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Cancers
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Patient-Centered Outcomes of Colorectal Cancer Surgery
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Patient-Centered Outcomes of Colorectal Cancer Surgery

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 9932

Special Issue Editors

Dr. Ira L. Leeds

E-Mail Website
Guest Editor
Yale School of Medicine, New Haven, CT, USA
Interests: colorectal cancer; quality of life; surgical outcomes; shared decision-making
Dr. Zhaomin Xu

E-Mail Website
Guest Editor
1. Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
2. Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
Interests: multidisciplinary teams; quality of life; colorectal surgery

Special Issue Information

Dear Colleagues,

The approaches to treating, curing, and palliating colorectal cancer have exponentially grown in the last two decades. Recent clinical trials continue to challenge and revise our profession’s understanding of the “best” oncologic therapy. However, a comprehensive understanding of the quality of life impact and formal ways of assessing it remain under emphasized.

The purpose of this Special Issue will be to highlight promising efforts to explore patient-centered outcomes of colorectal cancer surgery and the adjunctive therapies. Priority research areas include the following: comparative quality of life outcomes obtained by therapeutic approaches or sequencing, late effects of colorectal cancer surgery, quality of life considerations in patients with early-onset colorectal cancer, and novel approaches to shared decision-making. In addition to conventional studies of interest such as observational studies, clinical trials, and systematic reviews, we are also interested in highlighting novel research methods such as patient- and provider-oriented qualitative interviewing, mixed methods, healthcare economic modeling, and simulation-based models.

Dr. Ira L. Leeds
Dr. Zhaomin Xu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal cancer
  • quality of life
  • postoperative outcomes

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Published Papers (6 papers)

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Research

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8 pages, 561 KiB  
Article
Association Between Chemotherapy-Induced Peripheral Neuropathy and Low Anterior Resection Syndrome
by Samantha M. Linhares, Kurt S. Schultz, Nathan A. Coppersmith, Andrew C. Esposito, Ira L. Leeds, Haddon J. Pantel, Vikram B. Reddy and Anne K. Mongiu
Cancers 2024, 16(21), 3578; https://doi.org/10.3390/cancers16213578 - 23 Oct 2024
Cited by 1 | Viewed by 1140
Abstract
Introduction: Low anterior resection syndrome (LARS) can be a debilitating condition that develops after undergoing sphincter-preserving surgery for rectal cancer. Chemotherapy-induced peripheral neuropathy is a common side effect of platinum-based chemotherapy agents used as systemic therapy for rectal cancer treatment. The purpose of [...] Read more.
Introduction: Low anterior resection syndrome (LARS) can be a debilitating condition that develops after undergoing sphincter-preserving surgery for rectal cancer. Chemotherapy-induced peripheral neuropathy is a common side effect of platinum-based chemotherapy agents used as systemic therapy for rectal cancer treatment. The purpose of this study was to determine the potential relationship between CIPN and LARS. Methods: This was a retrospective review of patients who underwent a low anterior resection for rectal cancer and received systemic therapy contacted at least six months from the most recent surgery. Eligible patients were called and completed the relevant surveys over the phone or email. Results: There was a total of 42 patients who completed the surveys with 33 (79%) having major LARS. Presence of a diverting ileostomy was the only significantly differentcharacteristic in those with major LARS versus those without. CIPN was independently associated with LARS (p = 0.046) on linear regression when controlling for neoadjuvant chemoradiation, diverting ileostomy and tumor distance from the anal verge. Conclusions: Developing severe CIPN is associated with developing LARS. Further studies evaluating the etiology behind this relationship should be conducted. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
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Review

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10 pages, 248 KiB  
Review
Fertility Concerns Related to Surgery for Colorectal Cancer: An Under-Discussed Topic
by Samantha L. Savitch, Maedeh Marzoughi and Pasithorn A. Suwanabol
Cancers 2024, 16(19), 3376; https://doi.org/10.3390/cancers16193376 - 2 Oct 2024
Viewed by 1428
Abstract
As the incidence of colorectal cancer (CRC) increases among younger adults, the need for discussions regarding treatment-related infertility is growing. The negative impacts of gonadotoxic chemotherapy and pelvic radiation are well documented, but the role that surgical intervention for CRC plays in infertility [...] Read more.
As the incidence of colorectal cancer (CRC) increases among younger adults, the need for discussions regarding treatment-related infertility is growing. The negative impacts of gonadotoxic chemotherapy and pelvic radiation are well documented, but the role that surgical intervention for CRC plays in infertility is less clear. Additionally, treatment-related infertility counseling occurs infrequently. This review provides an overview of the connection between abdominal and pelvic surgery on male and female infertility and elucidates the role of surgeons in counseling to alleviate psychological distress in newly diagnosed patients. A review of the literature revealed that pelvic surgery leads to increased adhesion formation, which is known to be associated with female infertility. Furthermore, nerve damage from pelvic surgery has significant implications for ejaculatory issues in males and sexual dysfunction in both males and females, which ultimately impact pregnancy success. Patients have significant distress related to treatment-related infertility, and pre-treatment fertility counseling has been shown to alleviate some of this psychological burden. Nevertheless, many patients do not receive counseling, particularly in surgical clinics, despite surgeons often being the first providers to see newly diagnosed non-metastatic patients. Efforts should be made to enact protocols that ensure fertility conversations are being had with patients in surgical clinics and that patients are being referred to fertility specialists appropriately. This patient-centered approach will lessen the psychological burden placed on patients during a vulnerable time in their lives. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
16 pages, 850 KiB  
Review
Colorectal Cancer Outcomes: A Comparative Review of Resource-Limited Settings in Low- and Middle-Income Countries and Rural America
by Clare E. Jacobson, Calista M. Harbaugh, Kwabena Agbedinu and Gifty Kwakye
Cancers 2024, 16(19), 3302; https://doi.org/10.3390/cancers16193302 - 27 Sep 2024
Cited by 1 | Viewed by 2061
Abstract
Background/Objectives: Colorectal cancer remains a significant global health challenge, particularly in resource-limited settings where patient-centered outcomes following surgery are often suboptimal. Although more prevalent in low- and middle-income countries (LMICs), segments of the United States have similarly limited healthcare resources, resulting in stark [...] Read more.
Background/Objectives: Colorectal cancer remains a significant global health challenge, particularly in resource-limited settings where patient-centered outcomes following surgery are often suboptimal. Although more prevalent in low- and middle-income countries (LMICs), segments of the United States have similarly limited healthcare resources, resulting in stark inequities even within close geographic proximity. Methods: This review compares and contrasts colorectal cancer outcomes in LMICs with those in resource-constrained communities in rural America, utilizing an established implementation science framework to identify key determinants of practice for delivering high-quality colorectal cancer care. Results: Barriers and innovative, community-based strategies aimed at improving patient-centered outcomes for colorectal cancer patients in low resource settings are identified. We explore innovative approaches and community-based strategies aimed at improving patient-centered outcomes, highlighting the newly developed colorectal surgery fellowship in Sub-Saharan Africa as a model of innovation in this field. Conclusions: By exploring these diverse contexts, this paper proposes actionable solutions and strategies to enhance surgical care of colorectal cancer and patient outcomes, ultimately aiming to inform global health practices, inspire collaboration between LMIC and rural communities, and improve care delivery across various resource settings. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
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12 pages, 960 KiB  
Review
The Role of Frailty in the Treatment of Locally Advanced Rectal Cancer
by Grzegorz J. Stępień, Jakub Włodarczyk, Kasper Maryńczak, Mateusz Prusisz, Mateusz Porc, Marcin Włodarczyk, Anna Waśniewska-Włodarczyk and Łukasz Dziki
Cancers 2024, 16(19), 3287; https://doi.org/10.3390/cancers16193287 - 27 Sep 2024
Viewed by 1404
Abstract
Owing to the gradual aging of today’s population, an increase in the prevalence of frailty syndrome has been noticed. This complex state of health, characterized by decreased resilience and tolerance with concurrent increased vulnerability to stressors and adverse health-related factors, has drawn researchers’ [...] Read more.
Owing to the gradual aging of today’s population, an increase in the prevalence of frailty syndrome has been noticed. This complex state of health, characterized by decreased resilience and tolerance with concurrent increased vulnerability to stressors and adverse health-related factors, has drawn researchers’ attention in recent years. Rectal cancer, which constitutes ~30% of all colorectal cancers, is a disease noticeably related to the elderly. In its locally advanced form, it is conventionally treated with trimodal therapy—neoadjuvant chemoradiotherapy followed by total mesorectal excision and adjuvant chemotherapy. Despite its good clinical outcomes and improvement in rectal cancer local control, as evidenced by clinical trials, it remains unclear if all frail patients benefit from that approach since it may be associated with adverse side effects that cannot be handled by them. As old patients, and frail ones even more noticeably, are poorly represented in the clinical trials describing outcomes of the standard treatment, this article aims to review the current knowledge on the trimodal therapy of rectal cancer with an emphasis on novel approaches to rectal cancer that can be implemented for frail patients. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
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20 pages, 593 KiB  
Review
Journey through the Decades: The Evolution in Treatment and Shared Decision Making for Locally Advanced Rectal Cancer
by Racquel S. Gaetani, Keren Ladin and Jonathan S. Abelson
Cancers 2024, 16(16), 2807; https://doi.org/10.3390/cancers16162807 - 9 Aug 2024
Cited by 2 | Viewed by 1652
Abstract
The management of locally advanced rectal cancer has undergone significant transformations over the decades and optimal treatment approaches continue to evolve. There have been numerous advances in surgery, chemotherapy, and radiation therapy from the first description of the abdominoperineal resection in 1908, timing [...] Read more.
The management of locally advanced rectal cancer has undergone significant transformations over the decades and optimal treatment approaches continue to evolve. There have been numerous advances in surgery, chemotherapy, and radiation therapy from the first description of the abdominoperineal resection in 1908, timing of chemotherapy and radiation therapy in the late 20th and early 21st century, and most recently, the introduction of organ preservation or nonoperative management in 2004. Alongside these advancements, the concept of shared decision making in medicine has evolved, prompting a focus on patient-centered care. This evolution in practice has been fueled by a growing recognition of the importance of patient autonomy and the alignment of treatment options with patients’ values and preferences. With the growing number of possible treatment options, variability in patient counseling exists, highlighting the need for a standardized approach to shared decision making in locally advanced rectal cancer. This narrative review will describe the evolution of treatment options of locally advanced rectal cancer as well as the concept of shared decision making and decision aids, and will introduce a decision aid for patients with locally advanced rectal cancer who have achieved a complete clinical response and are eligible for watch and wait. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
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11 pages, 228 KiB  
Review
Low Anterior Resection Syndrome following Restorative Proctectomy for Rectal Cancer: Can the Surgeon Have Any Meaningful Impact?
by Richard C. Garfinkle and Nicholas P. McKenna
Cancers 2024, 16(13), 2307; https://doi.org/10.3390/cancers16132307 - 24 Jun 2024
Cited by 1 | Viewed by 1436
Abstract
Postoperative bowel dysfunction following restorative proctectomy, commonly referred to as Low Anterior Resection Syndrome (LARS), is a common long term sequela of rectal cancer treatment. While many of the established risk factors for LARS are non-modifiable, others may be well within the surgeon’s [...] Read more.
Postoperative bowel dysfunction following restorative proctectomy, commonly referred to as Low Anterior Resection Syndrome (LARS), is a common long term sequela of rectal cancer treatment. While many of the established risk factors for LARS are non-modifiable, others may be well within the surgeon’s control. Several pre-, intra-, and postoperative decisions may have a significant impact on postoperative bowel function. Some of these factors include the extent of surgical resection, surgical approach, choice of anastomotic reconstruction, and use of fecal diversion. This review article summarizes the available evidence regarding how surgical decision-making can affect postoperative bowel function. Full article
(This article belongs to the Special Issue Patient-Centered Outcomes of Colorectal Cancer Surgery)
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