Effects of preoperative chemoradiotherapy on anal sphincter functions and quality of life in patients with locally advanced rectal cancer: prospective, controlled study

SHORT HEAD AND SUMMARYEffects of Preoperative Chemoradiotherapy on Anal Sphincter Functions and Quality OfLife in Patients with Locally Advanced Rectal Cancer: Prospective, Controlled StudyAras Emre CANDA, MD.Dokuz Eylul University Department of Surgery, Inciraltı, Izmir - TURKEYObjective: The aim of this study is to assess the effects of preoperative chemoradiotherapy (CRT) onanorectal functions in patients with recal cancer.Material and Methods: Patients who were diagnosed with rectal cancer between February 2002 andMarch 2006 were included in the study (n=57) and divided into 2 groups as Group 1; patients treatedwith only sugery (n=26) and Group 2; patients underwent preoperative CRT (n=31). Anorectalmanometry, rectosigmoidoscopy, Wexner and fecal incontinence quality of life (FIQL) questionnaireevaluations were carried out.Results: Comparison of the two groups in terms of measurements at the postoperative 6th monthrevealed that maximum squeeze pressure was lower (P=0.018) and Wexner score was higher(P=0.006) in Group 2; there was no difference in FIQL questionnaire scores. Due to the comparisonof anorectal functions before and after CRT in Group 2, anal sphinctric pressures were detected to below, Wexner score and FIQL results were detected to be inversely effected by CRT.Conclusions: Preoperative CRT seems to affect anorectal functions negatively in short term and mostof these effects recover in the postoperative 6 months. However, negative effects particularly on theexternal anal sphincter might continue to exist and finally might have a negative impact on fecalcontinence. The possibility of the fact that CRT might negatively affect anoretcal functions in thelong term should be shared with the patient and the capacity of the anorectal function of the patientshould also be considered during planning of the treatment.1