Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial (COLOR II)

TY - JOUR

T1 - Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial (COLOR II)

AU - Andersson, J

AU - Abis, G

AU - Gellerstedt, M

AU - Angenete, E

AU - Angerås, U

AU - Cuesta, M A

AU - Jess, P

AU - Rosenberg, J

AU - Bonjer, H J

AU - Haglind, E

N1 - © 2014 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

PY - 2014/9

Y1 - 2014/9

N2 - Background This article reports on patient-reported sexual dysfunction and micturition symptoms following a randomized trial of laparoscopic and open surgery for rectal cancer. Methods Patients in the COLOR II randomized trial, comparing laparoscopic and open surgery for rectal cancer, completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR38 questionnaire before surgery, and after 4 weeks, 6, 12 and 24 months. Adjusted mean differences on a 100-point scale were calculated using changes from baseline value at the various time points in the domains of sexual functioning, sexual enjoyment, male and female sexual problems, and micturition symptoms. Results Of 617 randomized patients, 385 completed this phase of the trial. Their mean age was 67·1 years. Surgery caused an anticipated reduction in genitourinary function after 4 weeks, with no significant differences between laparoscopic and open approaches. An improvement in sexual dysfunction was seen in the first year, but some male sexual problems persisted. Before operation 64·5 per cent of men in the laparoscopic group and 55·6 per cent in the open group reported some degree of erectile dysfunction. This increased to 81·1 and 80·5 per cent respectively 4 weeks after surgery, and 76·3 versus 75·5 per cent at 12 months, with no significant differences between groups. Micturition symptoms were less affected than sexual function and gradually improved to preoperative levels by 6 months. Adjusting for confounders, including radiotherapy, did not change these results. Conclusion Sexual dysfunction is common in patients with rectal cancer, and treatment (including surgery) increases the proportion of patients affected. A laparoscopic approach does not change this. Registration number: NCT0029779 (http://www.clinicaltrials.gov). Symptoms worse postoperatively

AB - Background This article reports on patient-reported sexual dysfunction and micturition symptoms following a randomized trial of laparoscopic and open surgery for rectal cancer. Methods Patients in the COLOR II randomized trial, comparing laparoscopic and open surgery for rectal cancer, completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR38 questionnaire before surgery, and after 4 weeks, 6, 12 and 24 months. Adjusted mean differences on a 100-point scale were calculated using changes from baseline value at the various time points in the domains of sexual functioning, sexual enjoyment, male and female sexual problems, and micturition symptoms. Results Of 617 randomized patients, 385 completed this phase of the trial. Their mean age was 67·1 years. Surgery caused an anticipated reduction in genitourinary function after 4 weeks, with no significant differences between laparoscopic and open approaches. An improvement in sexual dysfunction was seen in the first year, but some male sexual problems persisted. Before operation 64·5 per cent of men in the laparoscopic group and 55·6 per cent in the open group reported some degree of erectile dysfunction. This increased to 81·1 and 80·5 per cent respectively 4 weeks after surgery, and 76·3 versus 75·5 per cent at 12 months, with no significant differences between groups. Micturition symptoms were less affected than sexual function and gradually improved to preoperative levels by 6 months. Adjusting for confounders, including radiotherapy, did not change these results. Conclusion Sexual dysfunction is common in patients with rectal cancer, and treatment (including surgery) increases the proportion of patients affected. A laparoscopic approach does not change this. Registration number: NCT0029779 (http://www.clinicaltrials.gov). Symptoms worse postoperatively

KW - Aged

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Laparoscopy

KW - Male

KW - Patient Satisfaction

KW - Quality of Life

KW - Rectal Neoplasms

KW - Rectum

KW - Sexual Dysfunction, Physiological

KW - Urination Disorders

U2 - 10.1002/bjs.9550

DO - 10.1002/bjs.9550

M3 - Journal article

C2 - 24924798

SN - 0007-1323

VL - 101

SP - 1272

EP - 1279

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 10

ER -