Low anterior resection syndrome in ovarian cancer patient: a prospective longitudinal study

Objectives To evaluate the prevalence of LARS-like symptoms in primary diagnosed ovarian cancer (OC) and the effect of surgery regarding recto-sigmoid resection.

Methods A prospective longitudinal observational cohort study was performed, including patients with newly diagnosed epithelial OC treated by primary or interval surgery with residual tumor less than 1 cm, between the years 2019 and 2021. Cases with stoma were excluded. Intestinal dysfunction was assessed through a known LARS score questionnaire, regarding flatus and/or feces incontinence, urgent, and frequent bowel peristalsis, which were answered pre- and postoperatively. Based on the scoring, the patient was classified in 3 subgroups: no(0-20), minor (21-29), and major LARS (30-42).

Results In total, 78 patients answered the score questionnaire before and after surgery. LARS-like symptoms increased from 34.6% (n=27: 24.4% minor; 10.2% major) preoperatively to 47.4% (n=37: 28.2% minor; 19.2% major) postoperatively, regardless of rectum resection. Pre- and postoperative LARS-like symptoms were predominantly reported in advanced stages FIGO III-IV (92.6% and 94.6%, respectively). Recto-sigmoid resection was performed in 52.6% (n=41) with primary end to end anastomosis, and was observed in 62.2% of LARS patient. In multivariate analysis, preoperative LARS-like symptoms, regardless of the severity, demonstrated the unique significant independent risk factor for postoperative LARS (p=0.017).

Conclusions LARS-like symptoms appear in one third of ovarian cancer patients preoperatively and could help to identify a high-risk group for such symptoms postoperatively. Recto-sigmoid resection seems to be performed frequently in LARS patients, but could not be identified as independent risk factor.

Publication History

Article published online:
11 October 2022