Low anterior resection syndrome (LARS) in ovarian cancer patients - A multi-centre comparative cohort study.

Harpain F; Kranawetter M; Zott T; Lazaridis II; Guenin MO; Ninkovic M; Kronberger IE; Tapiolas I; Basany EE; Dauser B; Herbst F; Koh C; Stift A; Teleky B; Reinthaller A; Grimm C; Riss S

doi:10.1016/j.ijsu.2020.04.019

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Journal article

Low anterior resection syndrome (LARS) in ovarian cancer patients - A multi-centre comparative cohort study.

Harpain F Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.
Kranawetter M Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria.
Zott T Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.
Lazaridis II Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland.
Guenin MO Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland.
Ninkovic M Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Kronberger IE Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Tapiolas I Department of Surgery, Colorectal Surgery Unit, Hospital Vall D'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Basany EE Department of Surgery, Colorectal Surgery Unit, Hospital Vall D'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.
Dauser B Department of Surgery, Hospital of St. John of God, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
Herbst F Department of Surgery, Hospital of St. John of God, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
Koh C Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camerdown, New South Wales, Australia.
Stift A Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.
Teleky B Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria.
Reinthaller A Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria.
Grimm C Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria.
Riss S Department of Surgery, Division of General Surgery, Medical University Vienna, Vienna, Austria. Electronic address: Stefan.riss@meduniwien.ac.at.

2020-04-19

Published in:

International journal of surgery (London, England). - 2020

Low anterior resection syndrome

Cytoreduction Surgical Procedures

English BACKGROUND
Low anterior resection syndrome (LARS) is a common functional disorder after low anterior resection impacting the quality of life. Data on LARS derives nearly exclusively from rectal cancer studies. Therefore, the study was designed to assess LARS in advanced epithelial ovarian cancer (EOC) patients, who underwent rectal resection and to compare it with a female rectal cancer cohort.

MATERIAL AND METHODS
A cross-sectional multi-centre analysis was performed on female patients suffering from either rectal or EOC who received a low anterior resection as part of their therapy regimen. None of the patients received pre- or postoperative radiotherapy. LARS was defined by using the validated LARS score and its severity was divided into "no", "minor" and "major LARS".

RESULTS
In total, 125 female patients (44.8% (n = 56) EOC vs. 55.2% (n = 69) rectal cancer patients) met the final inclusion criteria and were retrospectively analyzed. Baseline characteristics were comparable between the groups. Median follow-up was 22 (IQR 12-56) months. In total, 30.4% (n = 38) of the patient group reported bowel dysfunction after surgery. Rates of LARS were not significantly different between EOC and rectal cancer patients (major LARS 16.1% (n = 9) vs. 15.9% (n = 11); minor LARS 17.9% (n = 10) vs. 11.6% (n = 8); p = 0.984). The time interval between surgery and final assessment had no impact on the postoperative bowel function (p = 0.820).

CONCLUSION
LARS is a frequent and highly underreported postoperative disorder in EOC patients who require cytoreductive surgery with rectal resection. The functional outcome is comparable to female patients with rectal cancer who underwent low anterior resection without receiving radiotherapy.

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