Long-term outcomes and quality of life after rectal carcinoma surgery

Background: A cohort study was undertaken to investigate the long-term oncological outcome, late adverse effects and quality of life (QOL) after treatment for rectal cancer. Methods: This was an analysis of prospectively collected data from 268 consecutive patients with rectal carcinoma treated between 1995 and 1997 at the Department of Surgery, University Hospital Erlangen, Germany. Results: Median follow-up was 8.8 years. The overall 10-year survival rate was 48.1 per cent. Of 219 patients who had a curative resection, 67 developed recurrent disease and 13 had second malignancies. Seventy patients had either a permanent stoma or a late adverse effect. Anorectal dysfunction and small bowel obstruction were significantly more common among patients who had multimodal treatment (P < 0.001 and P = 0.049 respectively). Analysis of QOL in 97 long-term survivors showed that receiving chemoradiotherapy, a permanent stoma and lower-third rectal carcinoma were associated with significantly worse outcomes on several measures. Conclusion: Late adverse effects and recurrences occurred in a significant number of patients during long-term follow-up. QOL varied according to tumour location and treatment type.