Ha Ryun Kyong, Park Boram, Park Sung Chan, Chang Hee Jin, Oh Jae Hwan
Center for Colorectal Cancer, NCC Hospital, National Cancer Center, Goyang, Korea.
Biostatistics Collaboration Team, Research Institute, National Cancer Center, Goyang, Korea.
Ann Surg Treat Res. 2021 Feb;100(2):109-118. doi: 10.4174/astr.2021.100.2.109. Epub 2021 Feb 1.
This study was performed to evaluate the quality of life and genitourinary function after total mesorectal excision with lateral lymph node dissection compared to those after total mesorectal excision alone following neoadjuvant chemoradiotherapy for rectal cancer.
Among patients who underwent rectal cancer surgery after completing neoadjuvant chemoradiotherapy between September 2011 and October 2018 at the National Cancer Center, Korea, patients who completed the validated questionnaires before initiation of neoadjuvant chemoradiotherapy and at 3 months and 1 year postoperatively were included in this study. The European Organization for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (QLQ-C30), colorectal cancer-specific quality of life questionnaire (QLQ-CR38), and International Prostate Symptom Score (IPSS) questionnaire were used for collecting data.
The total mesorectal excision alone group and the total mesorectal excision with lateral lymph node dissection group included 52 and 38 patients, respectively. The second group included significantly younger patients (P = 0.024), had a higher incidence of clinical T4 stage disease (P = 0.033), estimated blood loss (P = 0.003), and longer operation time (P < 0.001). Significant differences were not observed between the groups with respect to the EORTC QLQ-C30, QLQ-CR38, and IPSS. Multivariable analysis showed that lateral lymph node dissection had no statistically significant association with postoperative urinary dysfunction (P = 0.953).
The overall quality of life and urinary function after total mesorectal excision does not differ significantly when lateral lymph node dissection is performed as well.
本研究旨在评估与新辅助放化疗后单纯行全直肠系膜切除术相比，新辅助放化疗后行全直肠系膜切除术加侧方淋巴结清扫术患者的生活质量和泌尿生殖功能。
在韩国国立癌症中心于2011年9月至2018年10月完成新辅助放化疗后接受直肠癌手术的患者中，纳入在新辅助放化疗开始前以及术后3个月和1年完成有效问卷的患者。使用欧洲癌症研究与治疗组织（EORTC）核心生活质量问卷（QLQ-C30）、结直肠癌特异性生活质量问卷（QLQ-CR38）和国际前列腺症状评分（IPSS）问卷收集数据。
单纯全直肠系膜切除术组和全直肠系膜切除术加侧方淋巴结清扫术组分别有52例和38例患者。第二组患者明显更年轻（P = 0.024），临床T4期疾病发生率更高（P = 0.033），估计失血量更多（P = 0.003），手术时间更长（P <0.001）。两组在EORTC QLQ-C30、QLQ-CR38和IPSS方面未观察到显著差异。多变量分析显示，侧方淋巴结清扫与术后排尿功能障碍无统计学显著关联（P = 0.953）。
行全直肠系膜切除术时同时行侧方淋巴结清扫，患者的总体生活质量和泌尿功能无显著差异。
