3040 - Patient-Reported Outcomes in Rectal Cancer: A Prospective Study of Treatments with Chemoradiotherapy Alone or Followed by Surgery

C. Martinez^1,2, A. Garant³, M. Buotros^2,4, C. A. V. Vasilevsky^2,4, A. Pang^2,4, N. Morin^2,4, K. Ma^2,4, S. Bukera², M. Lecavalier^2,4, and T. Vuong^2,4; ¹McGill University Health Centre, Montreal, QC, Canada, ²Jewish General Hospital, Montreal, QC, Canada, ³Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, ⁴McGill University, Montreal, QC, Canada

Purpose/Objective(s): Rectal cancer local control and outcomes have significantly improved with the combined used of neoadjuvant chemoradiotherapy (CRT) and total mesorectal excision (TME). This prospective study aims to evaluate the long-term incidence and severity low anterior resection syndrome (LARS) in patients undergoing CRT followed by TME and CRT-alone. Materials/

Methods: This study included all patients who received CRT followed by TME and underwent a lower anterior resection, as well as those treated solely with CRT. Assessments for low anterior resection syndrome (LARS) were conducted at baseline, 0-6 months, 7-12 months, and 13-24 months, utilizing validated questionnaires that categorized LARS into three groups: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (=30 points). Statistical analyses were performed using unpaired two-tailed t-tests, and significance was determined with a p-value < 0.05.
Results: A total of 40 patients underwent CRT+TME, while 41 patients received CRT-alone. The median age was 62.5 years and 62 years for patients treated with CRT+TME and CRT-alone, respectively. Baseline comparisons of patients treated with CRT + TME vs CRT with no LARS 40% vs 44.1%, minor LARS 20% vs 26.1%, and major LARS 40% vs 26.5% (p=0.28). At 0-6 months, CRT + TME vs CRT revealed no LARS 20% vs 46.2%, minor LARS 26.7% vs 15.4%, major LARS 53.4% vs 38.5% (p=0.9). At 7-12 months, CRT + TME vs CRT exhibited no LARS 44.4% vs 70%, minor LARS 33.3% vs 10%, major LARS 22.2% vs 20% (p=0.34). At 13-24 months, CRT + TME vs CRT demonstrated no LARS 18.2% vs 54.5%, minor LARS (36.4% vs 36.4%), major LARS 45.5% vs 9.1% (p=0.04*).
Conclusion: Patient-reported outcomes showed that the LARS incidence and severity at 2 years was significantly higher in patients treated with CRT followed by TME compared to those treated with CRT-alone. These findings are promising, implying that a non-operative approach may offer a superior quality of life compared to the conventional TME surgery.