Bowel dysfunction following pelvic organ cancer: a prospective study on the treatment effect in nurse-led late sequelae clinics

Figures & data

Figure 1. Symptoms at baseline. x-axis; patients as percentage, y-axis; symptoms.

LARS:Low anterior resection syndrome; PAC-SYM:Patient Assessment of Constipation-Symptoms; LS: late sequelae. *Indicate response options defined as a “severe symptom”. “All cancers” include nine patients with other cancers.

Figure 2. Flow chart of patients referred to the late sequelae (LS) clinics affiliated with the surgical departments. *The final questionnaire completed in relation to discharge from the LS clinics.

Table 1. Patient demographics, clinical characteristics and referrals of patients referred to and discharged from the late sequelae (LS) clinics affiliated with the surgical departments.

	Patients referred to the LS clinics (n = 380)^a	Patients discharged from the LS clinics (n = 169)^b
Age at baseline (median, range)	66 (27–93)	67 (31–86)
Female gender, n (%)	210 (55.3)	87 (51.5)
Cancer type, n (%)
Rectal cancer	175 (46.1)	86 (50.9)
Gynaecological	56 (14.7)	19 (11.2)
Cervical	31 (55.4)	10 (52.6)
Endometrial	10 (17.9)	4 (21.1)
Ovarian	4 (7.1)	2 (10.5)
Uterine	3 (5.4)	0 (0.0)
Vulvar	6 (10.7)	2 (10.5)
Vaginal	1 (1.8)	1 (5.3)
Tubal	1 (1.8)	0 (0.0)
Anal cancer	51 (13.4)	21 (12.4)
Colon cancer	45 (11.8)	21 (12.4)
Prostate cancer	44 (11.6)	20 (11.8)
Other	9 (2.4)	2 (1.2)
Cancer treatment, n (%)
Surgery	198 (52.1)	102 (60.4)
Radiotherapy	103 (27.1)	43 (25.4)
Surgery + radiotherapy	77 (20.3)	24 (14.2)
Chemotherapy only/chemical castration only	2 (0.5)	0 (0.0)
Chemotherapy during course of
cancer treatment, n (%)
Yes	164 (43.2)	68 (40.2)
No	212 (55.8)	99 (58.6)
Missing	4 (1.1)	2 (1.2)
Referred from, n (%)
The LS screening programme
or local departments^c	180 (47.4)	90 (53.3)
General practitioners within the
same regions	58 (15.3)	19 (11.2)
Other departments within the same
Region	116 (30.5)	50 (29.6)
General practitioners or departments
from other regions	20 (5.3)	7 (4.1)
Elsewhere	6 (1.6)	3 (1.8)
Days from cancer surgery or last radiotherapy to referral^d
(median, range)	668 (56–14130)	582.5 (56–6089)

^aSecond box of the flow chart/Figure 2. ^bLast box of the flow chart/Figure 2. ^cLocal departments; the surgical or gastroenterological departments at Aarhus and Aalborg University Hospitals. ^d23 and 3 patients missing, respectively.

Figure 3. The proportion of patients introduced to each treatment and the proportion of patients using the treatment at discharge from the LS clinics affiliated with the surgical departments. x-axis; treatments, y-axis; patients as percentages.

SNS: sacral nerve stimulation; TAI: transanal irrigation

Figure 4. Percentage of patients experiencing improvement, worsening or no change from baseline to discharge. x-axis; patients as percentages, y-axis; self-rated bowel function, impact of bowel function on QoL, symptom. Patients were excluded from the analysis if they at baseline reported self-rated bowel function as being the best possible or reported having no impact of bowel function on QoL. Only patients who presented with the symptom at baseline were included in the analysis. Patients discharged with a stoma (n = 5) were included only in analysis of self-rated bowel function and impact of bowel function on QoL.

QoL: quality of life

Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.