Quality of life after sphincter preservation surgery or abdominoperineal resection for low rectal cancer (ASPIRE): A long-term prospective, multicentre, cohort study
Sung‐Bum Kang, Jung Rae Cho, Seung‐Yong Jeong, Jae Hwan Oh, Soyeon Ahn, Sunkyu Choi, Duck‐Woo Kim, Bong Hwa Lee, Eui Gon Youk, Sung Chan Park, Seung Chul Heo, Doo-Seok Lee, Seung‐Bum Ryoo, Ji Won Park, Hyoung‐Chul Park, Sung-Min Lee, Sung Il Kang, Min Hyun Kim, Heung‐Kwon Oh, Rumi Shin, Min Jung Kim, Kyoung Ho Lee, Young-Hoon Kim, Kim Js, Keun‐Wook Lee, Hye Seung Lee, Hyun Jung Kim, Young Soo Park, Dae Kyung Sohn, Kyu Joo Park
Abstract
BACKGROUND: The long-term effects of radical resection on quality of life may influence the treatment selection. The objective of this study was to determine whether abdominoperineal resection has a better effect on the quality of life than sphincter preservation surgery at 3 years after surgery. METHODS: This prospective, cohort study included patients who underwent radical resection for low rectal cancer. The primary outcomes were European Organisation for Research and Treatment of Cancer QLQ-C30 and CR38 quality of life scores 3 years after surgery, which were compared with linear generalised estimating equations, after adjustment for baseline values, a time effect, and an interaction effect between time and treatment. The secondary outcomes included sexual-urinary functions and oncological outcomes. The study was registered with ClinicalTrials.gov (NCT01461525). FINDINGS: = 0•0052), but did not differ after adjustment. INTERPRETATION: In this long-term prospective study, abdominoperineal resection failed to meet the superiority to sphincter preservation surgery in terms of quality of life. Although the global quality of life scores did not differ between groups, this study suggests that sphincter preservation surgery can be an acceptable alternative to abdominoperineal resection for low rectal cancer, offering a better quality of life and sexual-urinary functions, with no increased oncological risk even after 3 years. FUNDING: Seoul National University Bundang Hospital, Korea.