ObjectiveTo analyze whether neoadjuvant chemoradiotherapy can impact patients’ anal function and quality of life after rectal cancer surgery.MethodThe domestic and international publications on the studies how the neoadjuvant chemoradiotherapy impacted patients’ anal function and quality of life were collected and reviewed.ResultsThe neoadjuvant chemoradiotherapy negatively impacted the patients’ anal function and quality of life, but which would be improved over time. The impact had no obvious difference between the long-course chemoradiotherapy and short-couse radiotherapy on the patients’ anal function and quality of life. Compared with the neoadjuvant chemoradiotherapy, the neoadjuvant chemotherapy might impact less on the anal function, but which still needed to evaluate the lower anterior resection syndrome (LARS) score. In present, it lacked evidence of a higher rate of anastomotic leakage caused by the neoadjuvant chemoradiotherapy, which might lead to the bowel dysfunction.ConclusionsNeoadjuvant chemoradiotherapy negatively impacts patients’ anal function and quality of life. Further studies are needed to figure out the best choice between long-course neoadjuvant chemoradiotherapy and short-couse radiotherapy. In long term, impact of neoadjuvant therapy can be improved over time and be accepted by patients. Some intervention treatments including medicine and operations are needed if major LARS occurs.
ObjectiveTo investigate whether neoadjuvant chemotherapy alone may affect recent anal function in patients with rectal cancer.MethodsThe structured data from the December 3, 2018 version of Database from Colorectal Cancer (DACCA) of West China Hospital were extracted . The follow-up investigation was performed within 2 weeks from December 3, 2018 to December 16, 2018 by the telephone. The postoperative anal function of patients with rectal cancer was evaluated by the lower anterior resection symptom (LARS) score questionnaire.ResultsA total of 209 patients with rectal cancer treated by the total mesolectal excision in the Department of Gastrointestinal Surgery of West China Hospital were included. One hundred and thirty-six patients of them were only treated with TME, while the other 73 patients were treated by the TME and neoadjuvant chemotherapy. As for the baseline data of the 2 groups, there was no difference in the age, body mass index, gender, surgical procedure, differentiation degree or anastomotic position (P>0.050), while the pathological staging (P=0.022) and postoperative recovery time (P<0.001) had the significant differences between these 2 groups. The postoperative 1-year LARS score was not associated with the gender, age, body mass index, pathological stage, physical comorbidity, neoadjuvant chemotherapy or time of postoperative recovery (P>0.050), but which was associated with the heart disease (P=0.019) or position of anastomosis (P=0.005). Moreover, the multivariate analysis showed that the higher anastomosis position was a protective factor for the LARS after 1 year (OR=0.706, P=0.003).ConclusionsThere is no significant difference in postoperative anal function between patients with rectal cancer treated with neoadjuvant chemotherapy or not . It suggests that neoadjuvant chemotherapy has no more additional adverse effects on postoperative anal function in patients either.