A Prospective longitudinal evaluation of quality of life after abdominoperineal resection

Abdominoperineal resection (APR) is a disfiguring procedure, frequently associated with significant urogenital dysfunction. The aim of this prospective study was to repeatedly assess quality of life (QoL) 1, 6, and 12 months after APR.

Twenty patients who underwent APR between June 2002 and September 2005 were considered for analysis. QoL was assessed using two self-rating validated questionnaires developed by the European Organization for Research and Treatment of Cancer (EORTC).

All patients were free of recurrence at time of last interview. At 1-year follow-up patients reported significant improvement in global QoL [scores: 53 +/- 23 (1 month) vs. 70 +/- 15 (1 year), P = 0.01], and physical function (74 +/- 16 vs. 91 +/- 12, P = 0.001). Patients also reported significant improvement in symptoms such as fatigue (39 +/- 30 vs. 15 +/- 19, P = 0.01); and pain (33 +/- 31 vs. 10 +/- 14, P = 0.01). By contrast, there was no improvement at 1 year for the following items: body image (75 +/- 33 vs. 75 +/- 30, P = 0.99), sexual dysfunction (10 +/- 21 vs. 21 +/- 27, P = 0.40); and stoma-related problems (19 +/- 14 vs. 11 +/- 28, P = 0.34).

One year after APR, patients demonstrated significant improvement in global QoL and tumor-related symptoms, while body image remained significantly altered. Similarly, treatment-related side effects did not improve over the time period considered.