Evaluation of surgical strategy for low anterior resection syndrome using preoperative low anterior resection syndrome score in China

Table 1 Group characteristics according to the preoperative low anterior resection syndrome prediction model categories

Parameters	All	No LARS, %	Minor LARS, %	Major LARS, %	P
					No vs minor	No vs major	Minor vs major
Patients	186	26 (13.98)	109 (58.6)	51 (27.42)
Age in years	59.35 ± 10.28	69.85 ± 8.03	60.51 ± 8.84	52.47 ± 9.14	< 0.001	< 0.001	< 0.001
Sex					0.029	0.026	< 0.001
Male	129 (69.35)	23 (12.37)	73 (39.25)	33 (17.74)
Female	57 (30.65)	3 (1.61)	36 (19.35)	18 (9.68)
TME/PME					< 0.001	< 0.001	< 0.001
TME	82 (44.09)	0 (0)	34 (18.28)	48 (25.81)
PME	104 (55.91)	26 (13.98)	75 (40.32)	3 (1.61)
Tumor height in cm	9.08 ± 3.32	13.69 ± 2.02	9.44 ± 2.60	6.08 ± 1.87	< 0.001	< 0.001	< 0.001
Stoma	86 (46.24)	3 (1.61)	37 (19.89)	46 (24.73)	0.024	< 0.001	< 0.001
Preoperative radiotherapy	51 (27.42)	0 (0)	17 (9.14)	34 (18.28)	0.043	< 0.001	< 0.001

Data are n (%) or mean standard deviation. TME/PME: Total mesorectal excision/partial mesorectal excision; LARS: Low anterior resection syndrome.

Table 2 Relationship between EORTC QLQ-C30 score and preoperative low anterior resection syndrome score in postoperative patients with rectal cancer, n = 186

C30 scales	No LARS	Minor LARS	Major LARS	P
				No vs minor	No vs major	Minor vs major
Total	26 (13.98)	109 (58.60)	51 (27.42)
PF	87.69 ± 17.96	88.38 ± 16.16	88.37 ± 12.35	0.836	0.627	0.571
RF	89.74 ± 17.69	85.63 ± 21.33	83.99 ± 19.99	0.303	0.163	0.47
EF	88.78 ± 17.79	88.46 ± 15.63	87.25 ± 13.16	0.773	0.284	0.243
CF	91.03 ± 15.08	87.31 ± 15.37	86.27 ± 15.88	0.184	0.154	0.713
SF	83.33 ± 25.39	81.80 ± 21.58	73.53 ± 20.05	0.386	0.018	0.007
Fatigue	21.37 ± 21.30	24.87 ± 22.17	28.32 ± 20.53	0.473	0.118	0.215
Nausea and vomiting	1.92 ± 5.43	2.29 ± 7.34	2.29 ± 7.47	0.963	0.863	0.851
Pain	8.33 ± 19.58	7.49 ± 13.89	11.44 ± 17.79	0.503	0.157	0.166
Dyspnea	3.85 ± 10.86	7.03 ± 14.40	8.50 ± 16.12	0.304	0.204	0.613
Sleep disturbance	10.26 ± 15.69	18.96 ± 25.40	16.99 ± 23.45	0.153	0.309	0.688
Appetite loss	8.97 ± 15.08	8.56 ± 15.32	5.23 ± 13.94	0.841	0.176	0.125
Constipation	20.51 ± 26.79	27.52 ± 26.00	20.26 ± 25.01	0.157	0.938	0.069
Diarrhea	12.82 ± 19.04	16.51 ± 19.58	24.18 ± 22.19	0.354	0.027	0.036
Financial impact	11.54 ± 16.17	17.74 ± 24.67	28.10 ± 30.82	0.382	0.028	0.044
Global quality of life	66.35 ± 27.54	69.50 ± 23.47	68.95 ± 18.71	0.767	0.965	0.67

Data are n (%) or mean standard deviation. CF: Cognitive functioning; EF: Emotional functioning; LARS: Low anterior resection syndrome; PF: Physical functioning; RF: Role functioning; SF: Social functioning.

Table 3 Relationship between the EORTC QLQ-CR29 score and preoperative low anterior resection syndrome score in postoperative patients with rectal cancer, n = 186

CR29 scales	No LARS	Minor LARS	Major LARS	P
				No vs minor	No vs major	Minor vs major
Total	26 (13.98)	109 (58.60)	51 (27.42)
Urinary frequency	16.03 ± 19.14	16.82 ± 18.36	13.07 ± 13.87	0.782	0.764	0.36
Blood and mucus in stool	3.21 ± 6.70	6.57 ± 11.12	10.78 ± 13.26	0.167	0.01	0.038
Body image	14.53 ± 18.53	15.09 ± 15.68	19.83 ± 14.96	0.463	0.068	0.022
Flatulence	25.76 ± 30.74	28.18 ± 28.60	34.67 ± 27.73	0.623	0.163	0.137
Fecal incontinence	13.04 ± 26.09	18.75 ± 23.60	30.61 ± 28.74	0.145	0.006	0.013
Sore skin	1.52 ± 7.11	6.25 ± 14.76	8.67 ± 17.57	0.143	0.067	0.416
Stool frequency	23.91 ± 29.23	23.20 ± 20.91	34.69 ± 20.37	0.703	0.039	0.002
Embarrassment	21.21 ± 37.86	32.64 ± 31.71	40.28 ± 33.66	0.046	0.012	0.215
Sexual interest (men)	21.05 ± 25.36	19.44 ± 23.57	23.53 ± 25.33	0.796	0.707	0.384
Impotence	11.76 ± 20.21	23.23 ± 29.22	28.13 ± 35.02	0.137	0.128	0.667
Sexual interest (women)	1	1	1
Dyspareunia	1	1	1
Urinary incontinence	2.56 ± 9.06	5.50 ± 13.24	1.31 ± 6.53	0.295	0.484	0.033
Dysuria	5.13 ± 15.47	2.14 ± 8.21	1.96 ± 7.92	0.35	0.366	0.896
Abdominal pain	7.69 ± 14.32	6.73 ± 14.89	9.15 ± 16.44	0.619	0.784	0.308
Buttock pain	6.41 ± 18.90	6.73 ± 15.57	11.76 ± 20.90	0.548	0.116	0.088
Bloating	16.67 ± 21.60	10.09 ± 16.67	11.11 ± 18.46	0.134	0.244	0.842
Dry mouth	12.82 ± 19.04	19.57 ± 20.39	20.26 ± 23.17	0.111	0.18	0.976
Hair loss	6.41 ± 13.40	12.23 ± 22.53	12.42 ± 18.81	0.316	0.177	0.577
Taste	8.97 ± 17.78	3.67 ± 10.48	5.88 ± 14.46	0.094	0.421	0.385
Anxiety	23.08 ± 26.28	27.52 ± 25.19	32.03 ± 26.63	0.383	0.157	0.304
Weight	11.54 ± 18.72	16.51 ± 22.96	15.69 ± 21.45	0.355	0.43	0.924

¹Score could not be calculated as a large number of respondents refused to answer these questions.

Data are n (%) or mean standard deviation. LARS: Low anterior resection syndrome

Table 4 Preoperative low anterior resection syndrome score and actual low anterior resection syndrome score crosstabulation

Parameter		POLARS score			Total
		No LARS	Minor LARS	Major LARS
Actual LARS score	No LARS	10	25	3	38
	Minor LARS	6	19	6	31
	Major LARS	10	65	42	117
Total		26	109	51	186

LARS: Low anterior resection syndrome; POLARS: Preoperative low anterior resection syndrome.