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Impact of a Temporary Stoma on the Quality of Life of Rectal Cancer Patients Undergoing Treatment

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Data from randomized controlled trials support use of a diverting stoma in rectal cancer patients with low anastomoses, but there is little data on how this impacts patient quality of life (QOL). This study prospectively evaluates QOL in stage I–III rectal cancer patients undergoing sphincter-preserving surgery (SPS) with a temporary diverting stoma.

Materials and Methods

Patents were identified from a prospective single-institution study of stage I–III rectal cancer patients undergoing SPS. Patients completed the EORTC C30/CR38 QOL scale preoperatively, at stoma closure, and at 6 months. The Stoma Quality of Life (SQOL) was administered at stoma closure. Subscales of the EORTC hypothesized to be affected by a diverting stoma were identified a priori. Longitudinal trends were analyzed using repeated measures ANOVA. Frequencies for responses on specific SQOL items were tabulated, and correlations between SQOL subscales and EORTC Global QOL assessed with Pearson correlation coefficient.

Results

Global QOL was reportedly good (mean score 70.2) and did not change with a temporary stoma (P = .83). Physical (P = .33), role (P = .07), and social function (P = .48) were also stable. Decreased body image was observed (P = .03). Stoma-related difficulties identified by the SQOL included sexual activity (53%), leakage (39%), discomfort in clothing (34%), concerns regarding privacy to empty pouch (32%), and feeling unattractive (31%). “Overall satisfaction with life,” Work/social function (P < .001), sexuality/body image (P = .01), and stoma function (P = .01) subscales of the SQOL correlated strongly with the EORTC Global QOL score (P < .001).

Conclusion

In this longitudinal study of QOL in rectal cancer patients with a temporary stoma, Global QOL was good despite significant stoma-related difficulties. Use of alternative research methodology is necessary to provide insight into why this contradiction exists.

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Acknowledgment

This research was funded through a Limited Project Grant from the American Society of Colon and Rectal Surgeons, and a Career Development Award from the American Society of Clinical Oncology.

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Authors and Affiliations

  1. University of Wisconsin, Madison, WI, USA

    Heather B. Neuman MD, MS

  2. Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Sujata Patil PhD, Sarah Fuzesi BA, W. Douglas Wong MD, Martin R. Weiser MD, José G. Guillem MD, Philip B. Paty MD, Garrett M. Nash MD, MPH & Larissa K. Temple MD, MS

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  1. Heather B. Neuman MD, MS
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  2. Sujata Patil PhD
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  3. Sarah Fuzesi BA
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  9. Larissa K. Temple MD, MS
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Correspondence to Larissa K. Temple MD, MS.

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Financial Disclosures

This work was supported by a Limited Project Grant from the American Society of Colon and Rectal Surgeons (HN) and by a Career Development Award from American Society of Clinical Oncology (LT).

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Neuman, H.B., Patil, S., Fuzesi, S. et al. Impact of a Temporary Stoma on the Quality of Life of Rectal Cancer Patients Undergoing Treatment. Ann Surg Oncol 18, 1397–1403 (2011). https://doi.org/10.1245/s10434-010-1446-9

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  • DOI: https://doi.org/10.1245/s10434-010-1446-9

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