Purpose: Colorectal cancer (CRC) significantly impacts the quality of life (QoL) of survivors, yet detailed assessments of long-term QoL are sparse. This study evaluates QoL among CRC survivors, examining the influence of different treatments and patient characteristics on outcomes. Methods: We conducted a cross-sectional study at a tertiary cancer center in Portugal, enrolling CRC patients who underwent curative surgery from 2013 to 2022. QoL was assessed using the EORTC QLQ-C30 and QLQ-CR29 at 1-, 3-, 5-, and 10-year follow-up intervals. Subgroup analyses were performed based on tumor location, radiotherapy administration, chemotherapy administration, presence of a stoma, and time since treatment, with sociodemographic and clinical factors examined on univariate and multivariate analysis. Results: Of the 825 eligible patients, 324 were invited and 179 participated (response rate: 55.2%). Overall, patients reported high global QoL and functional scores with low symptom scores, comparable to those of the general population. However, rectal cancer survivors experienced poorer outcomes in role and social functioning, body image, and symptom management. Those receiving radiotherapy or chemotherapy reported more symptoms, with chemotherapy recipients showing lower functional scores. Patients with a stoma had significantly lower QoL across functional and symptom scales. Long-term survivors reported decreased physical functioning. Multivariate analysis identified female gender, open surgery, and chemotherapy as factors associated with reduced QoL. Conclusion: This study highlights significant disparities in QoL outcomes between CRC survivors, with QoL influenced by gender, cancer location, radiotherapy or chemotherapy, stoma presence, and survivorship duration, underscoring the need for personalized support programs and tailored care plans.

Background: Surgical site infections (SSIs) are among the most common postoperative complications in colorectal surgery, and associate with increased morbidity, prolonged recovery, and higher healthcare costs. Most studies combine all SSI categories, potentially overestimating economic burden due to higher severity of organ/space infections. The specific cost impact of incisional SSIs—superficial and deep infections—remains underexplored, despite its prevention potential. This study aimed to evaluate hospital costs associated with incisional SSIs following colorectal resection. Methods: A retrospective cohort study was conducted at a tertiary oncologic center, including patients who underwent surgical resection for primary neoplasms of the colon, rectum, or anal canal between 2018 and 2023. Patients with incisional SSIs were matched 1:1 to controls without SSI using propensity scores based on demographic and surgical variables. Total hospital costs within 60 days postoperatively were analyzed using real-world, institution-specific cost data. Multivariate regression was used to identify independent cost predictors. Results: Among 985 eligible patients, 176 (17.9%) developed an incisional SSI. After matching, 346 patients (173 pairs) were included in the cost analysis. Mean hospital costs were significantly higher in the SSI group (€6,065.93 vs €5,089.97; P < 0.001), primarily due to prolonged hospitalization and increased outpatient care use (medical and nursing consultations). Incisional SSI was an independent predictor of higher costs, along with open surgery, comorbidities and stoma presence. Conclusions: Incisional SSIs associated with higher hospital costs after colorectal surgery. These findings support the implementation of targeted SSI prevention strategies to reduce complications and optimize healthcare resource use.

Background: Hand-assisted laparoscopic surgery (HALS) is a possible approach for rectal anterior resection (RAR). However, evidence supporting this technique remains limited. This study aims to evaluate the perioperative and oncological outcomes of HALS for RAR at a single tertiary oncology center. Methods: A retrospective observational study was conducted using a prospectively maintained database. Patients with primary adenocarcinoma of the rectosigmoid junction and rectum who underwent HALS for RAR between 1 January 2013 and 31 December 2022 were included. All surgeries were performed by a dedicated colorectal team composed of three surgeons. Results: Among the 1911 surgeries for primary colorectal cancer performed, 469 met the inclusion criteria. The median age was 66 (57–74) years and 63% of the patients were male. Most tumors were cT3-4 (78.9%) and cN+ (71.2%), and neoadjuvant therapy was administered in 70.0% of cases. Low RAR was performed in 73.1% of cases, and an anastomosis was constructed in 95% of cases. The median operative time was 152 (135–180) min, and the conversion rate was 3.8%. Major morbidity occurred in 10.0% of cases, with 30-day and 90-day mortality rates of 0.9% and 1.3%, respectively. The overall anastomotic leak rate was 12.1%, with 9.0% early leaks and 3.1% late leaks. A complete/near-complete mesorectal excision was achieved in 89.6% of cases and an R0 resection in 96.2% of cases. With a median follow-up of 87 months, the locoregional recurrence rate was 2.5%, whereas the distant recurrence rate was 5.9%. The 5-year overall survival was 82.6%. Conclusions: When performed by experienced teams, HALS for RAR is safe and feasible and is associated with a short operative time, low conversion rate, minimal morbidity, and optimal oncologic performance.