Prospective evaluation of bowel function and quality of life after colon cancer surgery – is it time for routine screening for late sequelae?

Authors

  • Annette Boesen Bräuner a Department of Surgery, Regional Hospital Viborg, Viborg, Denmark; b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  • Nicolas Avellaneda d General Surgical Department, Centro de Educación Médica e Investigaciones Clínicas “Noberto Quirno” (CEMIC), Buenos Aires, Argentina; e Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
  • Peter Christensen b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; e Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
  • Asbjørn Mohr Drewes b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; f Mech-Sense. Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; g Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • Katrine Jøssing Emmertsen b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; h Department of Surgery, Regional Hospital Randers, Randers, Denmark
  • Klaus Krogh b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; i Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
  • Søren Laurberg b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  • Michael Bødker Lauritzen b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; j Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
  • Uffe Schou Løve a Department of Surgery, Regional Hospital Viborg, Viborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  • Ole Thorlacius-Ussing b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; g Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; j Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
  • Therese Juul b Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Aalborg, Denmark; c Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; h Department of Surgery, Regional Hospital Randers, Randers, Denmark

DOI:

https://doi.org/10.1080/0284186X.2023.2246102

Keywords:

Colon cancer, late sequelae, bowel dysfunction, quality of life, screening

Abstract

Aim

Bowel dysfunction after colon cancer (CC) surgery is widely neglected in current follow up programmes. This study explored changes in bowel function and quality of life (QoL) from three (3 m) to twelve months (12 m) after surgery in CC patients undergoing right- or left-sided colon resection (RightSCR/LeftSCR) and investigated differences between the two groups 12 m after surgery.

Method

CC patients undergoing surgical resection in 2018–2020 at five surgical departments were included in this population-based prospective cohort study. Included patients completed electronic surveys consisting of a collection of validated scores 3 m and 12 m after surgery.

Results

A total of 708 CC patients (423 RightSCR, 285 LeftSCR) were included. In RightSCR, no improvement was observed from 3 m to 12 m in most scores/items, on the contrary, symptom worsening in flatus- and faecal incontinence and urgency was observed (p < 0.05). Also, the proportion of patients rating their bowel function as very good/good decreased (p < 0.05) in this group. In LeftSCR improvement was found in flatus and faecal incontinence, urgency and night-time defaecation (p < 0.02), while no improvement was observed in the remaining scores/items. At 12 m, higher proportions of RightSCR than LeftSCR reported loose stools, incontinence and urgency (all p < 0.001), whereas LeftSCR more often reported hard stools and flatus incontinence (p < 0.05). Among all CC patients 18.3% reported bowel-related impairment of QoL at 12 m with no differences between the two groups.

Conclusion

From 3 m to 12 m no significant change was observed in the majority of bowel function and QoL scores/items, however, some symptoms worsened in RightSCR, while a few improved in LeftSCR. Bowel dysfunction and impaired QoL were still common in both groups at 12 m, although the symptom pattern differed between the groups. These findings call for a systematic screening for bowel dysfunction to ensure early treatment of symptoms.

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Published

2023-09-02

How to Cite

Boesen Bräuner, A., Avellaneda, N., Christensen, P., Mohr Drewes, A., Jøssing Emmertsen, K., Krogh, K., … Juul, T. (2023). Prospective evaluation of bowel function and quality of life after colon cancer surgery – is it time for routine screening for late sequelae?. Acta Oncologica, 62(9), 1132–1142. https://doi.org/10.1080/0284186X.2023.2246102

Issue

Vol. 62 No. 9 (2023): Acta Oncologica

Section

Articles