TY - JOUR
T1 - Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis
AU - Alavi, Mubarika
AU - Wendel, Christopher S.
AU - Krouse, Robert S.
AU - Temple, Larissa
AU - Hornbrook, Mark C.
AU - Bulkley, Joanna E.
AU - McMullen, Carmit K.
AU - Grant, Marcia
AU - Herrinton, Lisa J.
N1 - Publisher Copyright:
© 2017, Society of Surgical Oncology.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is associated with patient, disease, and treatment characteristics. Methods: The cohort study included Kaiser Permanente members who were long-term (≥5 years) rectal cancer survivors with anastomosis. Bowel function was scored using the self-administered, 14-item Memorial Sloan-Kettering Cancer Center Bowel Function Index. Patient, cancer, and treatment variables were collected from the electronic medical chart. We used multiple regression to assess the relationship of patient- and treatment-related variables with the bowel function score. Results: The study included 381 anastomosis patients surveyed an average 12 years after their rectal cancer surgeries. The total bowel function score averaged 53 (standard deviation, 9; range, 31–70, higher scores represent better function). Independent factors associated with worse total bowel function score included receipt of radiation therapy (yes vs. no: 5.3-unit decrement, p < 0.0001), tumor distance from the anal verge (≤6 cm vs. >6 cm: 3.2-unit decrement, p < 0.01), and history of a temporary ostomy (yes vs. no: 4.0-unit decrement, p < 0.01). One factor measured at time of survey was also associated with worse total bowel function score: ever smoking (2.3-unit decrement, p < 0.05). The regression model explained 20% of the variation in the total bowel function score. Conclusions: Low tumor location, radiation therapy, temporary ostomy during initial treatment, and history of smoking were linked with decreased long-term bowel function following an anastomosis. These results should improve decision-making about surgical options.
AB - Background: Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is associated with patient, disease, and treatment characteristics. Methods: The cohort study included Kaiser Permanente members who were long-term (≥5 years) rectal cancer survivors with anastomosis. Bowel function was scored using the self-administered, 14-item Memorial Sloan-Kettering Cancer Center Bowel Function Index. Patient, cancer, and treatment variables were collected from the electronic medical chart. We used multiple regression to assess the relationship of patient- and treatment-related variables with the bowel function score. Results: The study included 381 anastomosis patients surveyed an average 12 years after their rectal cancer surgeries. The total bowel function score averaged 53 (standard deviation, 9; range, 31–70, higher scores represent better function). Independent factors associated with worse total bowel function score included receipt of radiation therapy (yes vs. no: 5.3-unit decrement, p < 0.0001), tumor distance from the anal verge (≤6 cm vs. >6 cm: 3.2-unit decrement, p < 0.01), and history of a temporary ostomy (yes vs. no: 4.0-unit decrement, p < 0.01). One factor measured at time of survey was also associated with worse total bowel function score: ever smoking (2.3-unit decrement, p < 0.05). The regression model explained 20% of the variation in the total bowel function score. Conclusions: Low tumor location, radiation therapy, temporary ostomy during initial treatment, and history of smoking were linked with decreased long-term bowel function following an anastomosis. These results should improve decision-making about surgical options.
UR - http://www.scopus.com/inward/record.url?scp=85026904584&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026904584&partnerID=8YFLogxK
U2 - 10.1245/s10434-017-6017-x
DO - 10.1245/s10434-017-6017-x
M3 - Article
C2 - 28785900
AN - SCOPUS:85026904584
SN - 1068-9265
VL - 24
SP - 3596
EP - 3603
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 12
ER -