Weijie Chen, Xiao Zhang, Xiaoyuan Qiu, Jiaolin Zhou, Guole Lin
{"title":"保留括约肌的肛门成形术可为极低位直肠癌男性患者保留可接受的排便功能。","authors":"Weijie Chen, Xiao Zhang, Xiaoyuan Qiu, Jiaolin Zhou, Guole Lin","doi":"10.3389/fonc.2024.1478467","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Conformal proctectomy with sphincter preservation (CPSP) is designed to preserve the rectal wall as much as possible in very low rectal cancer patients. Evaluations of anal function and quality of life outcomes are lacking.</p><p><strong>Methods: </strong>This study included male patients with very low (≤ 5 cm from the anal verge) rectal adenocarcinoma between January 1, 2020, and January 1, 2022. A LARS score questionnaire survey and EORTC-QLQ-CR38 questionnaire survey were administered.</p><p><strong>Results: </strong>A total of 21 very low rectal cancer patients were enrolled in follow-up. The average age of the patients was 56.7 years, the tumors were 1.9 ± 0.6 cm in size, and the distance from the anal verge was 4.8 ± 0.5 cm. All patients were followed up, and the mean follow-up period was 2.7 ± 0.5 years. The LARS score increased significantly from 4.1 ± 2.8 before surgery to 19.1 ± 6.0 at the 1<sup>st</sup> year after surgery (<i>P</i> < 0.001) and then decreased to 13.1 ± 4.2 (<i>P</i> < 0.001) at the 2<sup>nd</sup> year. The quality of life of patients was also lower at the 1<sup>st</sup> year after surgery (61.1 ± 9.6 vs. 74.2 ± 11.2, <i>P</i> < 0.001) and was restored at the 2<sup>nd</sup> year after surgery (80.6 ± 11.9 vs. 74.2 ± 11.2, <i>P</i> = 0.029). During standard follow-up at the outpatient department, no rectal tumor relapse was confirmed in these patients, although 2 patients were found to have suspected recurrence of local lymph node metastasis.</p><p><strong>Conclusions: </strong>These results suggest that the CPSP technique preserves acceptable defecation function and is a safe and feasible option for male patients with very low rectal cancer.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/, identifier ChiCTR2100052094.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"14 ","pages":"1478467"},"PeriodicalIF":3.5000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578961/pdf/","citationCount":"0","resultStr":"{\"title\":\"Conformal proctectomy with sphincter preservation retains acceptable defecation functions in very low rectal cancer male patients.\",\"authors\":\"Weijie Chen, Xiao Zhang, Xiaoyuan Qiu, Jiaolin Zhou, Guole Lin\",\"doi\":\"10.3389/fonc.2024.1478467\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Conformal proctectomy with sphincter preservation (CPSP) is designed to preserve the rectal wall as much as possible in very low rectal cancer patients. Evaluations of anal function and quality of life outcomes are lacking.</p><p><strong>Methods: </strong>This study included male patients with very low (≤ 5 cm from the anal verge) rectal adenocarcinoma between January 1, 2020, and January 1, 2022. A LARS score questionnaire survey and EORTC-QLQ-CR38 questionnaire survey were administered.</p><p><strong>Results: </strong>A total of 21 very low rectal cancer patients were enrolled in follow-up. The average age of the patients was 56.7 years, the tumors were 1.9 ± 0.6 cm in size, and the distance from the anal verge was 4.8 ± 0.5 cm. All patients were followed up, and the mean follow-up period was 2.7 ± 0.5 years. The LARS score increased significantly from 4.1 ± 2.8 before surgery to 19.1 ± 6.0 at the 1<sup>st</sup> year after surgery (<i>P</i> < 0.001) and then decreased to 13.1 ± 4.2 (<i>P</i> < 0.001) at the 2<sup>nd</sup> year. The quality of life of patients was also lower at the 1<sup>st</sup> year after surgery (61.1 ± 9.6 vs. 74.2 ± 11.2, <i>P</i> < 0.001) and was restored at the 2<sup>nd</sup> year after surgery (80.6 ± 11.9 vs. 74.2 ± 11.2, <i>P</i> = 0.029). During standard follow-up at the outpatient department, no rectal tumor relapse was confirmed in these patients, although 2 patients were found to have suspected recurrence of local lymph node metastasis.</p><p><strong>Conclusions: </strong>These results suggest that the CPSP technique preserves acceptable defecation function and is a safe and feasible option for male patients with very low rectal cancer.</p><p><strong>Clinical trial registration: </strong>https://www.chictr.org.cn/, identifier ChiCTR2100052094.</p>\",\"PeriodicalId\":12482,\"journal\":{\"name\":\"Frontiers in Oncology\",\"volume\":\"14 \",\"pages\":\"1478467\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2024-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578961/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fonc.2024.1478467\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fonc.2024.1478467","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Conformal proctectomy with sphincter preservation retains acceptable defecation functions in very low rectal cancer male patients.
Background: Conformal proctectomy with sphincter preservation (CPSP) is designed to preserve the rectal wall as much as possible in very low rectal cancer patients. Evaluations of anal function and quality of life outcomes are lacking.
Methods: This study included male patients with very low (≤ 5 cm from the anal verge) rectal adenocarcinoma between January 1, 2020, and January 1, 2022. A LARS score questionnaire survey and EORTC-QLQ-CR38 questionnaire survey were administered.
Results: A total of 21 very low rectal cancer patients were enrolled in follow-up. The average age of the patients was 56.7 years, the tumors were 1.9 ± 0.6 cm in size, and the distance from the anal verge was 4.8 ± 0.5 cm. All patients were followed up, and the mean follow-up period was 2.7 ± 0.5 years. The LARS score increased significantly from 4.1 ± 2.8 before surgery to 19.1 ± 6.0 at the 1st year after surgery (P < 0.001) and then decreased to 13.1 ± 4.2 (P < 0.001) at the 2nd year. The quality of life of patients was also lower at the 1st year after surgery (61.1 ± 9.6 vs. 74.2 ± 11.2, P < 0.001) and was restored at the 2nd year after surgery (80.6 ± 11.9 vs. 74.2 ± 11.2, P = 0.029). During standard follow-up at the outpatient department, no rectal tumor relapse was confirmed in these patients, although 2 patients were found to have suspected recurrence of local lymph node metastasis.
Conclusions: These results suggest that the CPSP technique preserves acceptable defecation function and is a safe and feasible option for male patients with very low rectal cancer.
期刊介绍：
Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.
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