{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:33:41Z","timestamp":1773984821853,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To prospectively evaluate the effect of preoperative radiotherapy followed by surgery versus surgery alone on patient\u2010reported outcomes (PROs) 1\u2009year after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Prospective observational cohort study in 127 colorectal cancer centres. Patients with rectal cancer completed European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC\u2010QLQ\u2010C30) and Colorectal module (\u2010CR29) questionnaires (thus providing PROs) before initialization of treatment [baseline (T0)] and at 12\u2009months after surgery [follow up (T1)]. The PRO data together with sociodemographic information were linked to clinical data. Relevant confounders were identified using directed acyclic graphs. The effect of preoperative radiotherapy on selected PROs 12\u2009months after surgery was estimated using adjusted tobit regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1635 patients with rectal cancer for whom both baseline and follow\u2010up PROs were available, 565 (35%) received preoperative radiotherapy. Twelve\u2009months after surgery, patients with surgery alone reported better scores for global health status\/Quality of Life, urinary incontinence, faecal incontinence (patients without stoma), dyspareunia (female patients) and impotence (male patients) than did patients receiving preoperative radiotherapy. The statistically significant effects ranged between 33.20 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.19) for impotence and 39.01 (<jats:italic>p<\/jats:italic>\u2009=\u20090.001, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090.10) for dyspareunia. For global health status\/QoL and urinary incontinence, no statistically significant effect could be found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Radiotherapy in addition to surgery negatively affects selected PROs 1\u2009year after surgery in patients with rectal cancer. Compared with surgery alone, patients report profoundly impaired bowel and sexual function after preoperative radiotherapy. However, global health status\/QoL was not affected statistically significantly. These results are an important argument for limiting preoperative radiotherapy to patients with a high risk of recurrence of rectal cancer and may facilitate informed decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>German Clinical Trial Registry Number DRKS00008724 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/drks.de\/search\/de\/trial\/DRKS00008724\">https:\/\/drks.de\/search\/de\/trial\/DRKS00008724<\/jats:ext-link>).<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.70158","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T04:19:26Z","timestamp":1752207566000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of preoperative radiotherapy on patient\u2010reported outcomes in rectal cancer"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1259-2379","authenticated-orcid":false,"given":"Robert","family":"Siegel","sequence":"first","affiliation":[{"name":"Colorectal Cancer Center, Department of Surgery Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, Campus Virchow Klinikum and Campus Charit\u00e9 Mitte  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora Tabea","family":"Sibert","sequence":"additional","affiliation":[{"name":"Department of Health Services Research German Cancer Society  Berlin Germany"},{"name":"Oncological Health Services Research, Department of Gynecology and Obstetrics University Hospital D\u00fcsseldorf, Heinrich\u2010Heine University D\u00fcsseldorf  Dusseldorf Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Breidenbach","sequence":"additional","affiliation":[{"name":"Department of Health Services Research German Cancer Society  Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0242-9428","authenticated-orcid":false,"given":"Cihan","family":"Gani","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Hospital T\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp Alexander","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Klinikum Rechts der Isar Technical University of Munich  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan Rolf","family":"Benz","sequence":"additional","affiliation":[{"name":"Department of Surgery Sindelfingen\u2010B\u00f6blingen Hospital  B\u00f6blingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Post","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Mannheim  Mannheim 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