Association Between Radiotherapy (±Chemotherapy) and the Severity of Low Anterior Resection Syndrome After Rectal...

Area of Science:

• Oncology
• Colorectal Surgery
• Radiation Oncology

Background:

• Low Anterior Resection Syndrome (LARS) is a common issue post-rectal cancer surgery.
• Pelvic radiotherapy (RT) and chemotherapy are suspected contributors to LARS.
• The influence of RT may be confounded by tumor location and ileostomy use.

Purpose of the Study:

• To determine if RT (with or without chemotherapy) independently increases LARS severity.
• To assess RT's risk beyond established factors like tumor location and diversion.
• To analyze LARS symptom patterns associated with RT.

Main Methods:

• Single-center observational cohort study of 182 rectal cancer patients (2013-2024).
• Validated LARS score assessed via telephone interview post-bowel continuity restoration.
• Multivariable logistic regression adjusted for tumor location and diverting ileostomy.

Main Results:

• 43.4% of patients experienced LARS, with 28.6% having major LARS.
• RT-treated patients showed higher LARS scores and major LARS prevalence (unadjusted).
• Adjusted models revealed tumor location and ileostomy as key predictors, not RT alone.

Conclusions:

• RT is associated with unadjusted bowel dysfunction and specific symptom patterns (urgency, clustering).
• Major LARS risk in this cohort was primarily explained by tumor location and diversion.
• Integrated risk stratification and early symptom management are crucial for LARS survivorship care.