Prevalence and determinants of low anterior resection syndrome following rectal cancer resection: a cross-sectional study

BACKGROUND: Low anterior resection syndrome (LARS) is a debilitating bowel dysfunction that frequently follows sphincter-preserving surgery for rectal cancer. This study aimed to assess the prevalence of LARS and identify its associated determinants in a cohort of rectal cancer survivors. METHODS: In this cross-sectional study, patients who underwent sphincter-preserving surgery for rectal cancer at least one year prior were recruited from the Shiraz Colorectal Cancer Surgery (SCORCS) registry. Based on symptom severity assessed via the LARS score, patients were categorized as having no, minor, or major LARS. Multivariable logistic regression analyses were employed to identify determinants associated with any LARS (minor or major vs. none) and major LARS (vs. no and minor combined). RESULTS: The prevalence of LARS was 53.7% (58/108), comprising minor LARS in 31.5% and major LARS in 22.2% of patients. Multivariable analysis identified older age (odds ratio [OR]: 1.04, 95% confidence interval [CI]: 1.01-1.08) and neoadjuvant radiotherapy (OR: 4.38, 95% CI: 1.54-12.45) as determinants for any LARS. For major LARS, independent determinants were older age (OR: 1.05, 95% CI: 1.01-1.10) and female sex (OR: 2.97, 95% CI: 1.02-8.60). There was no significant difference in quality-of-life domains across LARS severity groups. CONCLUSION: This study confirms a high prevalence of LARS among rectal cancer survivors. Neoadjuvant radiotherapy, older age, and female sex were identified as determinants of LARS in this cohort; however, due to the study's limitations, the findings should be interpreted cautiously.