Male sexual dysfunction after rectal cancer surgery: Results of a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for patients with lower rectal cancer: Japan Clinical Oncology Group Study JCOG0212

被引：106

作者：

Saito, S. ^{[1
]}

Fujita, S. ^{[2
]}

Mizusawa, J. ^{[3
]}

Kanemitsu, Y. ^{[4
]}

Saito, N. ^{[5
]}

Kinugasa, Y. ^{[6
]}

Akazai, Y. ^{[7
]}

Ota, M. ^{[8
]}

Ohue, M. ^{[9
]}

Komori, K. ^{[10
]}

Shiozawa, M. ^{[11
]}

Yamaguchi, T. ^{[12
]}

Akasu, T. ^{[13
]}

Moriya, Y. ^{[14
]}

机构：

[1] Yokohama Shin Midori Gen Hosp, Gastrointestinal Ctr, Div Surg, Midori Ku, 1726-7 Tokaichiba Cho, Yokohama, Kanagawa 2260025, Japan

[2] Tochigi Canc Ctr, Dept Surg, 4-9-13 Yonan, Utsunomiya, Tochigi 3200834, Japan

[3] Natl Canc Ctr, JCOG Data Ctr, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan

[4] Natl Canc Ctr, Colorectal Surg Div, Chuo Ku, 5-1-1 Tsukiji, Tokyo 1040045, Japan

[5] Natl Canc Ctr Hosp East, Dept Surg, 6-5-1 Kashiwanoha, Kashiwa, Chiba 2778577, Japan

[6] Shizuoka Canc Ctr, Dept Surg, 1007 Shimonagakubo, Nagaizumi, Shizuoka 4118777, Japan

[7] Okayama Saiseikai Gen Hosp, Dept Surg, Kita Ku, 1-17-18 Ifuku Cho, Okayama 7008511, Japan

[8] Yokohama City Univ, Dept Surg, Med Ctr, Minami Ku, 4-57 Urafune Cho, Yokohama, Kanagawa 2320024, Japan

[9] Osaka Med Ctr & Cardiovasc Dis, Dept Surg, Higashinari Ku, 1-3-3 Nakamichi, Osaka 5378511, Japan

[10] Aichi Canc Ctr Hosp, Dept Surg, Chikusa Ku, 1-1 Kanokoden, Nagoya, Aichi 4648681, Japan

[11] Kanagawa Canc Ctr, Dept Surg, Asahi Ku, 2-3-2 Nakao, Yokohama, Kanagawa 2418515, Japan

[12] Natl Hosp Org, Kyoto Med Ctr, Dept Surg, Fushimi Ku, 1-1 Kusafukamukaihata Cho, Kyoto 6128555, Japan

[13] Imperial Household Agcy Hosp, Chiyoda Ku, 1-2 Chiyoda, Tokyo 1000001, Japan

[14] Miki Hosp, Dept Surg, Maesawa Ku, 100 Ushizawauwano, Oushu, Iwate 0294201, Japan

来源：

EJSO | 2016年 / 42卷 / 12期

关键词：

Rectal cancer; Sexual dysfunction; Randomized controlled trial; Lymph node dissection; Erectile dysfunction; AUTONOMIC NERVE PRESERVATION; ERECTILE FUNCTION; HEALTH INVENTORY; CARCINOMA; RESECTION; BLADDER; IIEF-5;

D O I：

10.1016/j.ejso.2016.07.010

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: We conducted a randomized controlled trial (JCOG0212) to determine whether the outcome of mesorectal excision (ME) alone for rectal cancer is not inferior to that of ME with lateral lymph node dissection (LLND). The present study focused on male sexual dysfunction after surgery. Methodology: Eligibility criteria included clinical stage II/III rectal cancer, the lower margin of the lesion below the peritoneal reflection, the absence of lateral pelvic lymph node enlargement, and no preoperative radiotherapy. After confirmation of R0 resection by ME, patients were intraoperatively randomized. Questionnaires using the International Index of Erectile Function (IIEF-5) about the sexual function of men were collected before and 1 year after surgery. Sexual dysfunction incidence was defined as the ratio of patients showing sexual dysfunction after surgery relative to the number who had no erectile dysfunction before surgery. Results: Among 701 patients enrolled between June 2003 and August 2010, 472 males were included. Among them, 343 (73%) completed preoperative and postoperative questionnaires. According to the study protocol, the incidences of sexual dysfunction in patients who underwent ME alone and ME with LLND were 68% (17/25; 95%CI, 47-85%) and 79% (23/29; 95%CI, 60-92%), respectively (p = 0.37). Incidences of sexual dysfunction in patients with no or only mild erectile dysfunction before surgery who underwent ME alone and ME with LLND were 59% (48/81) and 71% (67/95), respectively (p = 0.15). Multivariate analysis identified age as the only risk factor for sexual dysfunction after surgery (p = 0.02). Conclusions: LLND may not increase sexual dysfunction incidence after rectal cancer surgery. This incidence is associated with increased age. (C) 2016 Elsevier Ltd, BASO The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：1851 / 1858

页数：8

共 29 条

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