Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Prevalence of bowel and pelvic floor dysfunction after colorectal cancer surgery and primary cancer treatment (#96)

Kin Yin Chan 1 2 , Michael Suen 1 2 , Susan Coulson 1 , Janindra Warusavitarne 3 , Janette Vardy 1 2
  1. The University of Sydney , Sydney, NSW, Australia
  2. Concord Repatriation General Hospital, Concord, NSW, Australia
  3. St. Mark's Hospital, London, UK

Aim: Bowel and pelvic floor dysfunction can be challenging after colorectal cancer (CRC) treatment. We examined the prevalence of both in CRC survivors treated with curative intent.

 

Methods: A prospective, longitudinal observational study of CRC patients following anterior resection surgery +/- neoadjuvant/adjuvant treatment attending Concord Hospital from 2019-2023. Bowel, bladder and sexual function were screened with the Low Anterior Resection Syndrome Score (LARS) and study-specific questionnaire at baseline (6+ months post bowel reconstruction) and minimum 12-months later. Primary outcome: LARS prevalence. Secondary outcomes included bladder and sexual dysfunction, and factors associated with LARS. Descriptive analysis and Chi-squared test were used.

 

Results: 103 patients completed baseline, and 75 follow-up assessments. Mean age 64.5 (SD13.2) years; 67 (65%) males. Fifty-three (51.5%) had sigmoid and 50 rectal cancer. Disease stage: 19 % stage I/II, 59 % stage III, 2% stage IV. Surgical procedure performed: high (54%), low (18%) and ultralow (27%) anterior resection. 30/103 (29 %) had temporary stoma, mean duration 8 months (range 1-17). Twelve (12%) had neoadjuvant treatment, 62/103 (60%) had adjuvant chemotherapy. Baseline time from bowel reconstruction mean 17.5 (range 6-72) months. 6/75 completed data excluded due to recurrence or lost to follow-up at 12-months. At baseline, 69/103 (67%) had No LARS, 33% had Minor (n=18) or Major LARS (n=16).  At 12-month assessment (n=75), LARS improved in 54%, 33% remained unchanged. Six had no LARS at baseline but developed LARS at follow-up. Bladder and sexual dysfunction symptoms at baseline were 34% and 23% respectively. Tumour site (p<0.0004), type of resection (p<0.0002), temporary stoma (p<0.0005) and neoadjuvant treatment (p<0.002) were associated with severity of LARS.

 

Conclusion: Bowel, bladder and sexual dysfunction is prevalent in CRC survivors. Bowel symptoms may continue to improve beyond 18-months after CRC treatment. Pelvic floor functional screening and rehabilitation should be considered for cancer survivorship care for CRC patients.