To assess LARS symptoms postoperatively and analyze symptom trajectories in rectal cancer patients after ileostomy reversal.
Approach:
Study Design: Retrospective cohort study of 134 rectal cancer patients who underwent low anterior resection with diverting ileostomy and subsequent reversal.
Data Collection: LARS scores recorded at 3, 6, 9, and 12 months postoperatively.
Analysis Method: Group-based trajectory modeling (GBTM) used to classify patients into symptom trajectory groups; multinomial logistic regression identified clinical factors associated with each trajectory.
Key Findings:
Three LARS symptom trajectories identified: mild and recovering (30.6%), moderate and fluctuating (40.3%), and severe and persistent (29.1%).
LARS scores declined overall over 12 months, with significant differences in severity among the three groups (P < 0.001).
Higher T stage, lower anastomotic height, and receipt of preoperative radiotherapy were associated with worse symptom trajectories.
Interpretation:
Preoperative radiotherapy, low anastomotic height, and advanced tumor stage increase the likelihood of severe and persistent LARS trajectories.
Limitations:
Retrospective design may introduce selection bias.
Single-center study limits generalizability of findings.
Conclusion:
Recognizing clinical factors influencing LARS trajectories may facilitate personalized postoperative recovery strategies.
Harold Burstein, MD, PhD, and Erica Mayer, MD, MPH discuss results from the TRAK-ER trial, which were presented at the 2026 ESMO Breast Cancer Congress.
