Auxiliary study of DACCA of West China Hospital: neoadjuvant chemotherapy alone does not affect recent anal function after rectal cancer surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Ruixuan ^1,2 , HE Xinlin ^1,2 , ZHANG Qiulu ^1,2 , AN Limin ^1,2 , HUANG Mingjun ³ ,  WANG Xiaodong ¹ , LI Li ¹

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Nursing, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Xiaodong, Email: lockwan@163.com

Keywords：

neoadjuvant chemotherapy; rectal cancer; lower anterior rectal resection syndrome; anal function; Database from Colorectal Cancer of West China Hospital

DOI：

10.7507/1007-9424.201903065

Video：

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Objective To investigate whether neoadjuvant chemotherapy alone may affect recent anal function in patients with rectal cancer.Methods The structured data from the December 3, 2018 version of Database from Colorectal Cancer (DACCA) of West China Hospital were extracted . The follow-up investigation was performed within 2 weeks from December 3, 2018 to December 16, 2018 by the telephone. The postoperative anal function of patients with rectal cancer was evaluated by the lower anterior resection symptom (LARS) score questionnaire.Results A total of 209 patients with rectal cancer treated by the total mesolectal excision in the Department of Gastrointestinal Surgery of West China Hospital were included. One hundred and thirty-six patients of them were only treated with TME, while the other 73 patients were treated by the TME and neoadjuvant chemotherapy. As for the baseline data of the 2 groups, there was no difference in the age, body mass index, gender, surgical procedure, differentiation degree or anastomotic position (P>0.050), while the pathological staging (P=0.022) and postoperative recovery time (P<0.001) had the significant differences between these 2 groups. The postoperative 1-year LARS score was not associated with the gender, age, body mass index, pathological stage, physical comorbidity, neoadjuvant chemotherapy or time of postoperative recovery (P>0.050), but which was associated with the heart disease (P=0.019) or position of anastomosis (P=0.005). Moreover, the multivariate analysis showed that the higher anastomosis position was a protective factor for the LARS after 1 year (OR=0.706, P=0.003).Conclusions There is no significant difference in postoperative anal function between patients with rectal cancer treated with neoadjuvant chemotherapy or not . It suggests that neoadjuvant chemotherapy has no more additional adverse effects on postoperative anal function in patients either.

Citation： YU Ruixuan, HE Xinlin, ZHANG Qiulu, AN Limin, HUANG Mingjun, WANG Xiaodong, LI Li. Auxiliary study of DACCA of West China Hospital: neoadjuvant chemotherapy alone does not affect recent anal function after rectal cancer surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(5): 595-601. doi: 10.7507/1007-9424.201903065 Copy

1.	Keane C, Wells C, O’Grady G, et al. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis, 2017, 19(8): 713-722.
2.	Trenti L, Galvez A, Biondo S, et al. Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study. Eur J Surg Oncol, 2018, 44(7): 1031-1039.
3.	Sturiale A, Martellucci J, Zurli L, et al. Long-term functional follow-up after anterior rectal resection for cancer. Int J Colorectal Dis, 2017, 32(1): 83-88.
4.	Okuyama T, Sameshima S, Takeshita E, et al. Therapeutic effects of oxaliplatin-based neoadjuvant chemotherapy and chemoradiotherapy in patients with locally advanced rectal cancer: a single-center, retrospective cohort study. World J Surg Oncol, 2018, 16(1): 105.
5.	汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 212-220.
6.	汪晓东, 李希, 何欣林. 数据库研究第一部分: 区域性医疗中心的结直肠癌与人群特征. 中国普外基础与临床杂志, 2019, 26(2): 92-95.
7.	李立. 结直肠癌外科应用技术的规范与创新(一). 中国普外基础与临床杂志, 2006, 13(1): 106-109.
8.	李立. 结直肠癌外科应用技术的规范与创新(二). 中国普外基础与临床杂志, 2006, 13(2): 222-226.
9.	李立. 结直肠癌外科应用技术的规范与创新(三). 中国普外基础与临床杂志, 2006, 13(3): 336-342.
10.	李立. 结直肠癌外科应用技术的规范与创新(四). 中国普外基础与临床杂志, 2006, 13(4): 461-468.
11.	李立. 结直肠癌外科应用技术的规范与创新(五). 中国普外基础与临床杂志, 2006, 13(5): 597-607.
12.	李立. 结直肠癌外科应用技术的规范与创新(六). 中国普外基础与临床杂志, 2006, 13(6): 719-723.
13.	李立. 结直肠癌外科应用技术的规范与创新(七). 中国普外基础与临床杂志, 2007, 14(1): 96-103.
14.	李立. 结直肠癌外科应用技术的规范与创新(八). 中国普外基础与临床杂志, 2007, 14(2): 216-221.
15.	李立. 结直肠癌外科应用技术的规范与创新(九). 中国普外基础与临床杂志, 2007, 14(3): 350-353.
16.	李立. 结直肠癌外科应用技术的规范与创新(十). 中国普外基础与临床杂志, 2007, 14(4): 481-484.
17.	李立. 结直肠癌外科应用技术的规范与创新(十一). 中国普外基础与临床杂志, 2007, 14(5): 592-593.
18.	李立. 结直肠癌外科应用技术的规范与创新(十二). 中国普外基础与临床杂志, 2007, 14(6): 716.
19.	李立. 结直肠癌外科应用技术的规范与创新(十三). 中国普外基础与临床杂志, 2008, 15(1): 67.
20.	李立. 结直肠癌外科应用技术的规范与创新(十四). 中国普外基础与临床杂志, 2008, 15(2): 140-141.
21.	李立. 结直肠癌外科应用技术的规范与创新(十五). 中国普外基础与临床杂志, 2008, 15(3): 215-217.
22.	Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg, 2012, 255(5): 922-928.
23.	曹玉兰, 魏立, 王春梅. 直肠癌前切除综合征评分量表的汉化及信效度评价. 解放军护理杂志, 2011, 28(24): 16-19.
24.	D’Ambrosio G, Picchetto A, Campo S, et al. Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results. Surg Endosc, 2019, 33(3): 941-948.
25.	Qin Q, Huang B, Cao W, et al. Bowel dysfunction after low anterior resection with neoadjuvant chemoradiotherapy or chemotherapy alone for rectal cancer: a cross-sectional study from China. Dis Colon Rectum, 2017, 60(7): 697-705.
26.	Kaneko M, Nozawa H, Emoto S, et al. Neoadjuvant imatinib therapy followed by intersphincteric resection for low rectal gastrointestinal stromal tumors. Anticancer Res, 2017, 37(9): 5155-5160.
27.	Ueki T, Manabe T, Inoue S, et al. A feasibility study of neoadjuvant xelox without radiotherapy for locally advanced lower rectal cancer. Anticancer Res, 2016, 36(2): 741-747.
28.	Kosugi C, Koda K, Tanaka K, et al. Evaluation of preoperative chemotherapy with modified OPTIMOX-1 plus bevacizumab in patients with advanced rectal cancer with factors contraindicative of curative surgery. Hepatogastroenterology, 2015, 62(140): 868-872.
29.	Canda AE, Terzi C, Gorken IB, et al. Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in rectal cancer patients. Int J Colorectal Dis, 2010, 25(2): 197-204.
30.	De Nardi P, Testoni SG, Corsetti M, et al. Manometric evaluation of anorectal function in patients treated with neoadjuvant chemoradiotherapy and total mesorectal excision for rectal cancer. Dig Liver Dis, 2017, 49(1): 91-97.
31.	Romaniszyn M, Richter P, Walega P, et al. Low-anterior-resection syndrome. How does neoadjuvant radiotherapy and low resection of the rectum influence the function of anal sphincters in patients with rectal cancer? Preliminary results of a functional assessment study. Pol Przegl Chir, 2012, 84(4): 177-183.
32.	Quezada-Diaz F, Jimenez-Rodriguez RM, Pappou EP, et al. Effect of neoadjuvant systemic chemotherapy with or without chemoradiation on bowel function in rectal cancer patients treated with total mesorectal excision. J Gastrointest Surg, 2019, 23(4): 800-807.
33.	Koushi K, Nishizawa Y, Kojima M, et al. Association between pathologic features of peripheral nerves and postoperative anal function after neoadjuvant therapy for low rectal cancer. Int J Colorectal Dis, 2016, 31(12): 1845-1852.
34.	Nishizawa Y, Fujii S, Saito N, et al. Differences in tissue degeneration between preoperative chemotherapy and preoperative chemoradiotherapy for colorectal cancer. Int J Colorectal Dis, 2012, 27(8): 1047-1053.
35.	Kakodkar R, Gupta S, Nundy S. Low anterior resection with total mesorectal excision for rectal cancer: functional assessment and factors affecting outcome. Colorectal Dis, 2006, 8(8): 650-656.
36.	Kera T, Kawai H, Yoshida H, et al. Physical and psychological characteristics of the community-dwelling elderly with heart disease. Nihon Koshu Eisei Zasshi, 2017, 64(1): 3-13.
37.	Ekkarat P, Boonpipattanapong T, Tantiphlachiva K, et al. Factors determining low anterior resection syndrome after rectal cancer resection: A study in Thai patients. Asian J Surg, 2016, 39(4): 225-231.

1. Keane C, Wells C, O’Grady G, et al. Defining low anterior resection syndrome: a systematic review of the literature. Colorectal Dis, 2017, 19(8): 713-722.
2. Trenti L, Galvez A, Biondo S, et al. Quality of life and anterior resection syndrome after surgery for mid to low rectal cancer: A cross-sectional study. Eur J Surg Oncol, 2018, 44(7): 1031-1039.
3. Sturiale A, Martellucci J, Zurli L, et al. Long-term functional follow-up after anterior rectal resection for cancer. Int J Colorectal Dis, 2017, 32(1): 83-88.
4. Okuyama T, Sameshima S, Takeshita E, et al. Therapeutic effects of oxaliplatin-based neoadjuvant chemotherapy and chemoradiotherapy in patients with locally advanced rectal cancer: a single-center, retrospective cohort study. World J Surg Oncol, 2018, 16(1): 105.
5. 汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 212-220.
6. 汪晓东, 李希, 何欣林. 数据库研究第一部分: 区域性医疗中心的结直肠癌与人群特征. 中国普外基础与临床杂志, 2019, 26(2): 92-95.
7. 李立. 结直肠癌外科应用技术的规范与创新(一). 中国普外基础与临床杂志, 2006, 13(1): 106-109.
8. 李立. 结直肠癌外科应用技术的规范与创新(二). 中国普外基础与临床杂志, 2006, 13(2): 222-226.
9. 李立. 结直肠癌外科应用技术的规范与创新(三). 中国普外基础与临床杂志, 2006, 13(3): 336-342.
10. 李立. 结直肠癌外科应用技术的规范与创新(四). 中国普外基础与临床杂志, 2006, 13(4): 461-468.
11. 李立. 结直肠癌外科应用技术的规范与创新(五). 中国普外基础与临床杂志, 2006, 13(5): 597-607.
12. 李立. 结直肠癌外科应用技术的规范与创新(六). 中国普外基础与临床杂志, 2006, 13(6): 719-723.
13. 李立. 结直肠癌外科应用技术的规范与创新(七). 中国普外基础与临床杂志, 2007, 14(1): 96-103.
14. 李立. 结直肠癌外科应用技术的规范与创新(八). 中国普外基础与临床杂志, 2007, 14(2): 216-221.
15. 李立. 结直肠癌外科应用技术的规范与创新(九). 中国普外基础与临床杂志, 2007, 14(3): 350-353.
16. 李立. 结直肠癌外科应用技术的规范与创新(十). 中国普外基础与临床杂志, 2007, 14(4): 481-484.
17. 李立. 结直肠癌外科应用技术的规范与创新(十一). 中国普外基础与临床杂志, 2007, 14(5): 592-593.
18. 李立. 结直肠癌外科应用技术的规范与创新(十二). 中国普外基础与临床杂志, 2007, 14(6): 716.
19. 李立. 结直肠癌外科应用技术的规范与创新(十三). 中国普外基础与临床杂志, 2008, 15(1): 67.
20. 李立. 结直肠癌外科应用技术的规范与创新(十四). 中国普外基础与临床杂志, 2008, 15(2): 140-141.
21. 李立. 结直肠癌外科应用技术的规范与创新(十五). 中国普外基础与临床杂志, 2008, 15(3): 215-217.
22. Emmertsen KJ, Laurberg S. Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg, 2012, 255(5): 922-928.
23. 曹玉兰, 魏立, 王春梅. 直肠癌前切除综合征评分量表的汉化及信效度评价. 解放军护理杂志, 2011, 28(24): 16-19.
24. D’Ambrosio G, Picchetto A, Campo S, et al. Quality of life in patients with loco-regional rectal cancer after ELRR by TEM versus VLS TME after nChRT: long-term results. Surg Endosc, 2019, 33(3): 941-948.
25. Qin Q, Huang B, Cao W, et al. Bowel dysfunction after low anterior resection with neoadjuvant chemoradiotherapy or chemotherapy alone for rectal cancer: a cross-sectional study from China. Dis Colon Rectum, 2017, 60(7): 697-705.
26. Kaneko M, Nozawa H, Emoto S, et al. Neoadjuvant imatinib therapy followed by intersphincteric resection for low rectal gastrointestinal stromal tumors. Anticancer Res, 2017, 37(9): 5155-5160.
27. Ueki T, Manabe T, Inoue S, et al. A feasibility study of neoadjuvant xelox without radiotherapy for locally advanced lower rectal cancer. Anticancer Res, 2016, 36(2): 741-747.
28. Kosugi C, Koda K, Tanaka K, et al. Evaluation of preoperative chemotherapy with modified OPTIMOX-1 plus bevacizumab in patients with advanced rectal cancer with factors contraindicative of curative surgery. Hepatogastroenterology, 2015, 62(140): 868-872.
29. Canda AE, Terzi C, Gorken IB, et al. Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in rectal cancer patients. Int J Colorectal Dis, 2010, 25(2): 197-204.
30. De Nardi P, Testoni SG, Corsetti M, et al. Manometric evaluation of anorectal function in patients treated with neoadjuvant chemoradiotherapy and total mesorectal excision for rectal cancer. Dig Liver Dis, 2017, 49(1): 91-97.
31. Romaniszyn M, Richter P, Walega P, et al. Low-anterior-resection syndrome. How does neoadjuvant radiotherapy and low resection of the rectum influence the function of anal sphincters in patients with rectal cancer? Preliminary results of a functional assessment study. Pol Przegl Chir, 2012, 84(4): 177-183.
32. Quezada-Diaz F, Jimenez-Rodriguez RM, Pappou EP, et al. Effect of neoadjuvant systemic chemotherapy with or without chemoradiation on bowel function in rectal cancer patients treated with total mesorectal excision. J Gastrointest Surg, 2019, 23(4): 800-807.
33. Koushi K, Nishizawa Y, Kojima M, et al. Association between pathologic features of peripheral nerves and postoperative anal function after neoadjuvant therapy for low rectal cancer. Int J Colorectal Dis, 2016, 31(12): 1845-1852.
34. Nishizawa Y, Fujii S, Saito N, et al. Differences in tissue degeneration between preoperative chemotherapy and preoperative chemoradiotherapy for colorectal cancer. Int J Colorectal Dis, 2012, 27(8): 1047-1053.
35. Kakodkar R, Gupta S, Nundy S. Low anterior resection with total mesorectal excision for rectal cancer: functional assessment and factors affecting outcome. Colorectal Dis, 2006, 8(8): 650-656.
36. Kera T, Kawai H, Yoshida H, et al. Physical and psychological characteristics of the community-dwelling elderly with heart disease. Nihon Koshu Eisei Zasshi, 2017, 64(1): 3-13.
37. Ekkarat P, Boonpipattanapong T, Tantiphlachiva K, et al. Factors determining low anterior resection syndrome after rectal cancer resection: A study in Thai patients. Asian J Surg, 2016, 39(4): 225-231.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Auxiliary study of DACCA of West China Hospital: neoadjuvant chemotherapy alone does not affect recent anal function after rectal cancer surgery

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