Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis

Mubarika Alavi, Christopher S. Wendel, Robert S Krouse, Larissa Temple, Mark C. Hornbook, Joanna E. Bulkley, Carmit K. McMullen, Marcia Grant, Lisa J. Herrinton

Research output: Contribution to journalArticle

5 Scopus citations


Background: Bowel function in long-term rectal cancer survivors with anastomosis has not been characterized adequately. We hypothesized that bowel function is associated with patient, disease, and treatment characteristics. Methods: The cohort study included Kaiser Permanente members who were long-term (≥5 years) rectal cancer survivors with anastomosis. Bowel function was scored using the self-administered, 14-item Memorial Sloan-Kettering Cancer Center Bowel Function Index. Patient, cancer, and treatment variables were collected from the electronic medical chart. We used multiple regression to assess the relationship of patient- and treatment-related variables with the bowel function score. Results: The study included 381 anastomosis patients surveyed an average 12 years after their rectal cancer surgeries. The total bowel function score averaged 53 (standard deviation, 9; range, 31–70, higher scores represent better function). Independent factors associated with worse total bowel function score included receipt of radiation therapy (yes vs. no: 5.3-unit decrement, p < 0.0001), tumor distance from the anal verge (≤6 cm vs. >6 cm: 3.2-unit decrement, p < 0.01), and history of a temporary ostomy (yes vs. no: 4.0-unit decrement, p < 0.01). One factor measured at time of survey was also associated with worse total bowel function score: ever smoking (2.3-unit decrement, p < 0.05). The regression model explained 20% of the variation in the total bowel function score. Conclusions: Low tumor location, radiation therapy, temporary ostomy during initial treatment, and history of smoking were linked with decreased long-term bowel function following an anastomosis. These results should improve decision-making about surgical options.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAnnals of Surgical Oncology
StateAccepted/In press - Aug 7 2017

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Alavi, M., Wendel, C. S., Krouse, R. S., Temple, L., Hornbook, M. C., Bulkley, J. E., McMullen, C. K., Grant, M., & Herrinton, L. J. (Accepted/In press). Predictors of Bowel Function in Long-term Rectal Cancer Survivors with Anastomosis. Annals of Surgical Oncology, 1-8.