Functional and oncological outcomes in advanced colorectal cancer
(2026) In Lund University, Faculty of Medicine Doctoral Dissertation Series- Abstract
- Advanced colorectal cancer (CRC) often requires extensive surgery to achieve tumour-free resection margins, the most important predictive factor for long-term survival. The performed surgery may result in substantial tissue loss and the need for perineal, vaginal and urological reconstructions. This thesis evaluates quality of life (QoL), functional, oncological and survival outcomes in patients with advanced pelvic malignancy using local and national cohorts.
Paper I evaluated aspects of QoL in patients with advanced pelvic malignancy requiring perineal flap reconstruction. High general health scores were recorded despite difficulties in mobility, anxiety/depression, pain/discomfort and fatigue. Sexual dysfunction was common,... (More) - Advanced colorectal cancer (CRC) often requires extensive surgery to achieve tumour-free resection margins, the most important predictive factor for long-term survival. The performed surgery may result in substantial tissue loss and the need for perineal, vaginal and urological reconstructions. This thesis evaluates quality of life (QoL), functional, oncological and survival outcomes in patients with advanced pelvic malignancy using local and national cohorts.
Paper I evaluated aspects of QoL in patients with advanced pelvic malignancy requiring perineal flap reconstruction. High general health scores were recorded despite difficulties in mobility, anxiety/depression, pain/discomfort and fatigue. Sexual dysfunction was common, affecting both sexes. Physical tests showed adequate functionality in everyday life.
Paper II studied short-term postoperative outcomes in patients with pelvic malignancy requiring
perineal flap reconstruction. Approximately one-fourth of the patients experienced surgical complications classified as Clavien-Dindo ≥ III. Flap-related complications were common but were usually treated conservatively. Patients undergoing reconstruction with a vertical rectus abdominis myocutaneous flap had higher complication rates compared with patients who received a gluteal flap.
Paper III provided a step-by-step description of the gluteus maximus special flap used to reconstruct the posterior vaginal wall.
Paper IV examined survival as well as local and distant recurrence in patients with CRC undergoing urinary tract resections. Patients who underwent total cystectomy were compared with those who underwent partial cystectomy and ureter resection. There was no difference in 5-year overall survival or
distant recurrence between the groups. Ureter resection was associated with significantly higher rates of local recurrence.
Paper V evaluated short- and long-term complications after CRC surgery including urinary tract resections, focusing on urological complications. Urological complications were common. Ureteral stricture was the most common indication for long-term intervention. Patients undergoing total
cystectomy had higher complication rates compared with other resections. One-third of patients experienced a decline in kidney function. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/90aeefe6-dba9-4d37-a354-739034751218
- author
- Assi, Hanin LU
- supervisor
- opponent
-
- Professor Burger, Pim, Maastricht University
- organization
- publishing date
- 2026
- type
- Thesis
- publication status
- published
- subject
- in
- Lund University, Faculty of Medicine Doctoral Dissertation Series
- issue
- 2026:89
- pages
- 92 pages
- publisher
- Lund University, Faculty of Medicine
- defense location
- Kvinnoklinikens aula, Jan Waldenströms gata 47, Skånes Universitetssjukhus i Malmö
- defense date
- 2026-06-05 09:00:00
- ISSN
- 1652-8220
- ISBN
- 978-91-8021-887-0
- language
- English
- LU publication?
- yes
- id
- 90aeefe6-dba9-4d37-a354-739034751218
- date added to LUP
- 2026-04-30 10:34:22
- date last changed
- 2026-05-12 12:59:53
@phdthesis{90aeefe6-dba9-4d37-a354-739034751218,
abstract = {{Advanced colorectal cancer (CRC) often requires extensive surgery to achieve tumour-free resection margins, the most important predictive factor for long-term survival. The performed surgery may result in substantial tissue loss and the need for perineal, vaginal and urological reconstructions. This thesis evaluates quality of life (QoL), functional, oncological and survival outcomes in patients with advanced pelvic malignancy using local and national cohorts. <br/>Paper I evaluated aspects of QoL in patients with advanced pelvic malignancy requiring perineal flap reconstruction. High general health scores were recorded despite difficulties in mobility, anxiety/depression, pain/discomfort and fatigue. Sexual dysfunction was common, affecting both sexes. Physical tests showed adequate functionality in everyday life. <br/>Paper II studied short-term postoperative outcomes in patients with pelvic malignancy requiring <br/>perineal flap reconstruction. Approximately one-fourth of the patients experienced surgical complications classified as Clavien-Dindo ≥ III. Flap-related complications were common but were usually treated conservatively. Patients undergoing reconstruction with a vertical rectus abdominis myocutaneous flap had higher complication rates compared with patients who received a gluteal flap. <br/>Paper III provided a step-by-step description of the gluteus maximus special flap used to reconstruct the posterior vaginal wall. <br/>Paper IV examined survival as well as local and distant recurrence in patients with CRC undergoing urinary tract resections. Patients who underwent total cystectomy were compared with those who underwent partial cystectomy and ureter resection. There was no difference in 5-year overall survival or <br/>distant recurrence between the groups. Ureter resection was associated with significantly higher rates of local recurrence. <br/>Paper V evaluated short- and long-term complications after CRC surgery including urinary tract resections, focusing on urological complications. Urological complications were common. Ureteral stricture was the most common indication for long-term intervention. Patients undergoing total <br/>cystectomy had higher complication rates compared with other resections. One-third of patients experienced a decline in kidney function.}},
author = {{Assi, Hanin}},
isbn = {{978-91-8021-887-0}},
issn = {{1652-8220}},
language = {{eng}},
number = {{2026:89}},
publisher = {{Lund University, Faculty of Medicine}},
school = {{Lund University}},
series = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
title = {{Functional and oncological outcomes in advanced colorectal cancer}},
url = {{https://lup.lub.lu.se/search/files/248852313/Avhandling_Hanin_Assi_LUCRIS.pdf}},
year = {{2026}},
}