The following is the summary of “Case-Matched Comparison of Functional and Quality of Life Outcomes of Local Excision and Total Mesorectal Excision Following Chemoradiotherapy for Rectal Cancer” published in December 2022 issue of Diseases of the Colon & Rectum by Brachet, et al.
Standard curative treatment for intermediate and low-grade rectal cancer consists of neoadjuvant chemoradiotherapy followed by aggressive surgery. Patients may have a decline in gastrointestinal and genitourinary function and quality of life if they get all of these treatments at once. It is possible to reduce the risk of rectal complications is possible by using the rectal sparing technique of local excision in patients who have shown a good clinical response to neoadjuvant treatment. The purpose of this research is to examine whether rectal cancer patients fare better after local excision or traditional laparoscopic total mesorectal excision following a course of chemoradiation.
This model is a look backward at previous research. The environment portrayed is that of a single tertiary care facility. Patients were enrolled if they were diagnosed with intermediate or low-grade rectal cancer between January 2010 and December 2018 and if they were candidates for chemoradiation therapy and could have access to conservative surgery at our institution. In terms of age, sex, BMI, tumor height, and surgical year, researchers paired patients who had local excision with those with total mesorectal excision. Validated questionnaires were used to assess changes in quality of life and gastrointestinal and urinary tract functioning. The repercussions on the economy and society were evaluated as well. About 44 patients undergoing local excision volunteered to participate, and and aired with 44 patients undergoing total mesorectal excision.
Global health status (P<0.01), emotional function (P=0.035), social function (P=0.04), and body image (P=0.04) were all the better for patients who had undergone local excision. Local excision patients fared better on the low anterior resection syndrome score (rate of the major syndrome, 23..8% vs. 54.5%; P<0.01) and the particular fecal incontinence subscale score (P<0.01). Similar results were seen in both groups with regard to sexual and urinary function. It was shown that professional standing was less affected by local excision (35.7% vs. 76.5%; P=0.03). The study has a few flaws, including its retroactive nature and limited sample size. Following chemoradiation, individuals with rectal cancer who have surgery typically benefit more from a local excision than a whole mesorectal excision in terms of bowel function and quality of life.
