The following is the summary of “Assessment of Patient-Reported Outcomes in Patients with Anal Squamous-Cell Cancer Undergoing Combined Modality Therapy” published in the December 2022 issue of Diseases of the Colon & Rectum by James, et al.

There is a lack of data on the long-term effects of combined modality therapy for anal squamous-cell carcinoma on the bowel, sexual, and urine function. The purpose of this research was to examine the effects of combined modality treatment over the long term. A prospective collection of patient-reported outcome surveys was used for this retrospective analysis. The research was carried out in a single establishment. about 143 people who were diagnosed with stage I–III anal cancer and had chemoradiation treatment completed the survey. Measures of bowel, sexual, and urine function reported by patients were the primary outcomes of this research.

At the outset, 39% of patients had significant low anterior resection syndrome. There was no statistically significant change over time in the prevalence of major low anterior resection syndrome (38%; 95% CI, 31%-46%) (OR 0.95; 95% CI, 0.74-1.21; P=0.7). Patients who already had severe low anterior resection syndrome at baseline had a significantly higher risk of developing the syndrome after undergoing a resection (OR 20.7; 95% CI 4.70-91.3; P<0.001), as did females (OR 2.14; 95% CI, 1.01-4.56; P=0.047). Females reported a nonsignificant increase in sexual arousal during sexual activity after therapy (β  for 1 year = 0.15; 95% CI, -0.01 to 0.32; P=0.072), while males reported a nonsignificant decrease in confidence in achieving and maintaining an erection (β  for 1 year = -0.33; 95% CI, -0.66 to 0.00; P=0.053).

This was a self-selected, single-center study of patients who voluntarily participated in the survey. Major low anterior resection syndrome is present at baseline and in a sizable number of patients is still affected by it even after effective therapy for anal cancer. The greatest predictor of developing major low anterior resection syndrome during therapy was the presence of the condition at baseline. Even up to 2 years after the medication had stopped, bowel, sexual, and urine function had not improved. Poor bowel function at baseline is a risk factor for bowel dysfunction after treatment and should be discussed with patients beforehand.