Laparoscopic, Endoscopic and Robotic Surgery (Sep 2021)
The EORTC QLQ-C30 and QLQ-CR29 may play a complementary role to LARS score in evaluating the quality of life for patients following laparoscopic and robotic rectal cancer surgery
Abstract
Objective: To analyze whether the European Organisation for Treatment and Research of Cancer (EORTC) Quality of Life Questionnaires (QLQ-C30 and QLQ-CR29) complement the low anterior resection of rectum syndrome (LARS) score in evaluating the quality of life of patients who underwent laparoscopic or robotic rectal cancer surgery. Methods: Initially, 335 patients who underwent laparoscopic or robotic rectal cancer surgery were randomly selected at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from June 2013 to September 2020. All the patients took the questionnaires of LARS score, QLQ-C30 and QLQ-CR29. Totally, questionnaires filled out by 224 patients were qualified after screening. Patients were divided into three groups according to LARS score: No LARS group (score 0–20), minor LARS group (score 21–29) and major LARS group (score 30–42). The scores of QLQ-C30 as well as QLQ-CR29 among the three groups were compared. Results: Major, minor and no LARS groups had 140 cases, 40 cases and 44 cases respectively. In the scales of QLQ-C30, significant differences were discovered in global quality of life, physical function, role function, emotional function, cognitive function, social function, fatigue, pain, dyspnea, sleep disturbance, constipation and diarrhea between the no and major LARS groups (p < 0.05). While the differences were only found in global quality of life and diarrhea between the minor and major LARS groups (p < 0.05). In QLQ-CR29, scales of urinary frequency, blood and mucus in stool, body image, flatulence, fecal incontinence, sore skin, stool frequency, embarrassment, impotence, abdominal pain, buttock pain, bloating, dry mouth, hair loss, taste, anxiety and weight, had significant differences between the no and major LARS groups (p < 0.05). Only six scales, ie blood and mucus in stool, flatulence, fecal incontinence, stool frequency, embarrassment and dysuria had significant differences between the minor and major LARS groups (p < 0.05). Conclusion: For patients following laparoscopic or robotic low anal sphincter preserving surgery, LARS score, QLQ-C30 and QLQ-CR29 scores are consistent in overall trends. To guide disease evaluation and individualized treatment, as well as to evaluate efficacy, we suggest getting pre- and post-operative LARS scores incorporating QLQ-C30 and QLQ-CR29 scores as a comprehensive evaluation system.
