Chandramohan K, Mohandas Mithun, Muralee Madhu, Wagh Mira Sudham, George Preethi Sara, Geethakumari B S, Mayadevi L
Department of Surgical Services, Regional Cancer Centre, Thiruvananthapuram, India.
Division of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram, India.
Indian J Surg Oncol. 2025 Feb;16(1):172-181. doi: 10.1007/s13193-024-01991-1. Epub 2024 Aug 10.
Rectal cancer and its treatment significantly affect the quality of life (QOL) of the patients. Standard treatment for locally advanced rectal cancer is neoadjuvant radiation therapy followed by surgery and surgical options include sphincter-preserving surgeries (SPS) or abdominoperineal resection (APR). This study aims at determining the pattern of changes in quality of life of patients undergoing rectal cancer surgery using the FACT-C (Malayalam) questionnaire. The Malayalam translation of Functional Assessment of Cancer Therapy for Colorectal Cancer (FACT-C) questionnaire which was previously validated was used to assess the QOL in a prospective study of 102 rectal cancer patients who underwent surgery. QOL scores were recorded at four time points-preoperative, and postoperative at 1 month, 3 months, and 1 year after surgery. Means of QOL scores were compared using paired -test. The overall FACT-C score and scores of all four QOL domains-physical, emotional, social, and functional well being domains-dropped significantly at 1 month after surgery. Most profound fall in scores was noticed with the physical well being (PWB) domain followed by the functional well being (FWB) domain. QOL scores did not differ between patients who underwent SPS and APR. QOL score recovery was faster in APR patients compared to patients who had SPS. No significant difference was noted in overall QOL scores or individual scores of each domain between different age groups, sex, type of procedure (laparoscopic or open), stage of disease, or adjuvant therapy. Faster improvement of QOL scores of social domain was noted in patients with age < 60 years. Female patients were shown to have faster improvement in most of the QOL scores after surgery, though not statistically significant. Rectal cancer surgery results in fall in quality of life scores of all domains and gradual improvement of scores is seen over 1 year. QOL recovery is faster in young patients but sex, stage of disease, type of surgery, and surgical approach are not found to significantly affect the pattern of QOL scores. Patients undergoing APR are shown to have early recovery of QOL scores at 3 months after surgery while the same is attained at the end of 1 year in patients undergoing anterior resection with temporary stoma.
直肠癌及其治疗方法会显著影响患者的生活质量（QOL）。局部晚期直肠癌的标准治疗方法是新辅助放疗，然后进行手术，手术选择包括保留括约肌手术（SPS）或腹会阴联合切除术（APR）。本研究旨在使用FACT-C（马拉雅拉姆语）问卷确定接受直肠癌手术患者的生活质量变化模式。在一项针对102例接受手术的直肠癌患者的前瞻性研究中，使用先前已验证的结直肠癌功能评估问卷（FACT-C）的马拉雅拉姆语翻译版本来评估生活质量。在术前以及术后1个月、3个月和1年这四个时间点记录生活质量评分。使用配对t检验比较生活质量评分的均值。术后1个月时，总体FACT-C评分以及身体、情感、社会和功能健康这四个生活质量领域的评分均显著下降。身体幸福感（PWB）领域的评分下降最为显著，其次是功能幸福感（FWB）领域。接受SPS和APR的患者之间生活质量评分没有差异。与接受SPS的患者相比，APR患者的生活质量评分恢复更快。不同年龄组、性别、手术类型（腹腔镜或开放手术）、疾病分期或辅助治疗之间，总体生活质量评分或各领域的个体评分均未发现显著差异。年龄＜60岁的患者社会领域生活质量评分改善更快。女性患者术后大多数生活质量评分改善更快，尽管无统计学意义。直肠癌手术导致所有领域的生活质量评分下降，且在1年内评分逐渐改善。年轻患者的生活质量恢复更快，但性别、疾病分期、手术类型和手术方式并未发现对生活质量评分模式有显著影响。接受APR的患者术后3个月生活质量评分早期恢复，而接受临时造口的前切除术患者在术后1年末达到相同水平。
