Comparing Quality of Life in Rectal Cancer Survivors Managed With Watch-and-Wait Versus Surgery

Area of Science:

• Oncology
• Surgical Oncology
• Patient-Reported Outcomes

Background:

• Nonoperative (watch-and-wait) management is gaining acceptance for rectal cancer patients with a complete clinical response post-neoadjuvant therapy.
• Evaluating long-term quality of life (QoL) differences between surgical intervention and watch-and-wait is critical for optimizing patient care.

Purpose of the Study:

• To compare the long-term quality of life (QoL) outcomes for rectal cancer survivors managed with surgery versus a watch-and-wait strategy after chemoradiotherapy.

Main Methods:

• A cross-sectional study of 78 rectal cancer survivors treated between 2011-2019.
• Participants were grouped into: sustained watch-and-wait, surgery after regrowth, or standard surgery post-chemoradiotherapy.
• Patient-reported outcome measures were analyzed using multivariable linear regression, adjusting for relevant covariates.

Main Results:

• Surgery was independently associated with significantly lower QLQ-C30 summary scores and social functioning.
• Patients undergoing surgery reported higher levels of pain, bowel dysfunction, urinary issues, and embarrassment.
• Comorbidity burden negatively impacted overall quality of life.

Conclusions:

• Surgical intervention following chemoradiotherapy for rectal cancer is linked to diminished long-term quality of life and increased symptom burden.
• The findings underscore the necessity for ongoing symptom monitoring and tailored care plans for rectal cancer survivors.