The impact of neoadjuvant chemotherapy on low anterior resection syndrome after rectal cancer resection: A 6 Months longitudinal follow-up

Abstract

Summary: Background/objective: Neoadjuvant radiotherapy plays a vital role in rectal cancer treatment, but impairs postoperative bowel function, leading to low anterior resection syndrome (LARS). Neoadjuvant chemotherapy alone might avoid the negative effect of radiotherapy on bowel function. This study aims to assess the impact of neoadjuvant chemotherapy on LARS and the development of LARS over the first 6 months after surgery. Methods: Rectal cancer patients were prospectively recruited during June 30, 2018 and December 24, 2019. Bowel function was assessed by the LARS score, which was taken at 1 month, 3 months, and 6 months after surgery via phone call interview. Patients were divided into two groups based on whether they received neoadjuvant chemotherapy (group A) or not (group B). Results: A total of 97 patients were included in the analysis. There was no significant difference between the LARS scores at 1 month, 3 months, and 6 months of both groups. The LARS score at 6 months showed a significant decrease from that of 1 month and 3 months in group B (P < 0.05, P < 0.01) and in all patients (P < 0.05, P = 0.001), and significant difference was found between the LARS scores in group A at the three timepoints (P < 0.05). No significant difference was found between the scores at 1 month and 3 months in both groups and in all patients. Conclusion: Neoadjuvant chemotherapy alone did not have a negative impact on LARS. The bowel function after surgery started to show significant improvement at 6 months after surgery.

Keywords

• Bowel function
• Low anterior resection syndrome
• Neoadjuvant chemotherapy
• Rectal cancer