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Aminisani et al.                                                                                                                                                           Quality of life among rectal cancer patients

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           score  of  QOL  might  be  affected. At  the  time  of  this   cancer statistics. CA Cancer J Clin 2011;61:69-90.
           study  we  could  not  access  to  surgery  profile  of  the   3.   Ozols RF, Herbst RS, Colson YL, Gralow J, Bonner J, Curran WJ Jr,
                                                                 Eisenberg BL, Ganz PA, Kramer BS, Kris MG, Markman M, Mayer
           patients, then the information about preserving       RJ, Raghavan D, Reaman GH, Sawaya R, Schilsky RL, Schuchter
           sphincter was not available, however evidence showed   LM, Sweetenham JW,  Vahdat LT,  Winn RJ; American Society of
           that sphincter-ablating procedures do not necessarily   Clinical Oncology. Clinical cancer advances 2006: major research
           reduce QOL in patients with rectal cancer .           advances in cancer treatment, prevention, and screening -- a report
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           This  study  reported  a  relatively  low  score  of  QOL   2007;25:146-62.
           among patients with rectal cancer compared to      4.   Obias VJ, Reynolds HL Jr. Multidisciplinary teams in the management
           studies  from  other  countries.  In  general  treatment   of rectal cancer. Clin Colon Rectal Surg 2007;20:143-7.
           option and stage of disease, and physical activity were   5.   Vignali A, De Nardi P. Multidisciplinary treatment of rectal cancer in
                                                                 2014: where are we going? World J Gastroenterol 2014;20:11249-61.
           important predictive factors of QOL. The presence of   6.   Bowling A. Measuring disease: a review of disease-specific quality of
           a modifiable factor is an opportunity for interventional   life measurement scales. England: Open University Press; 2001.
           strategies to improve the QOL via physical activity   7.   Marventano S, Forjaz M, Grosso G, Mistretta A, Giorgianni G, Platania
           modification. Organised screening is recommended to   A, Gangi S, Basile F, Biondi A. Health related quality of life in colorectal
           improve the stage at presentation and concordance     cancer patients: state of the art. BMC Surg 2013;13 Suppl 2:S15.
           with treatment guidelines is also recommended.     8.   Grumann MM, Noack EM, Hoffmann IA, Schlag PM. Comparison of
                                                                 quality of life in patients undergoing abdominoperineal extirpation or
           DECLARATIONS                                       9.   anterior resection for rectal cancer. Ann Surg 2001;233:149-56.
                                                                 Li X, Song X, Chen Z, Li M, Lu L, Xu Y, Zhan W, He Y, Xu K.
                                                                 Quality of life in rectal cancer patients after radical surgery: a survey
           Authors’ contributions                                of Chinese patients. World J Surg Oncol 2014;12:161.
           Involved in design of the protocol of the study and all   10.  Engel J, Kerr J, Schlesinger-Raab A, Eckel R, Sauer H, Hölzel D.
           drafts of the manuscript, and reviewed and agreed the   Quality of life in rectal cancer patients: a four-year prospective study.
           final draft of the manuscript: N. Aminisani, M. Fatemi,   Ann Surg 2003;238:203-13.
           P. Sarbakhsh, A. Nikanfar, A. Eftekharsadat, E. Jafari  11.  Ministry  of  Health  and  Medical  Education.  Cancer  office.  Cancer
                                                                 registration  country reports  2009. Iran,  2012. Available  in Persian
           Did data collection and analysis: M. Fatemi, E. Jafari  from: crc.tums.ac.ir. [Last accessed on 26 September 2017]
           Supervised  and  supported  data collection:  N.   12.  Nikbakht  HA,  Aminisani  N,  Asghari-Jafarabadi  M, Hosseini  SR.
           Aminisani, A. Nikanfar, A. Eftekharsadat              Trends in the incidence of colorectal cancer and epidemiologic and
           Supervised the data analysis: N.  Aminisani, P.       clinical  characteristics  of survivors in babol city in 2007-2012.  J
           Sarbakhsh                                             Babol Univ Med Sci 2015;17:7-14.
                                                              13.  Ali Nikbakht H, Aminisani N, Asghari Jafarabadi M, Hosseini SR.
           Financial support and sponsorship                     Quality of life and its determinants among colorectal cancer survivors.
                                                                 J Kermanshah Univ Med Sci 2015;19:84-92.
           This study was funded by the Haematology  and      14.  Tsunoda A, Nakao K, Watanabe M, Matsui N, Tsunoda Y. Health-
           Oncology Research Centre and Centre for Training and   related quality of life in patients with colorectal cancer who
           Research on Health Management of Tabriz University    receive  oral  uracil  and  tegafur  plus  leucovorin.  Jpn  J  Clin  Oncol
           of Medical Sciences.                                  2010;40:412-9.
                                                              15.  Nicolussi AC, Sawada NO. Quality of life of patients with colorectal
           Conflicts of interest                                 cancer who were receiving complementary therapy. Acta Paulista de
           There are no conflicts of interest.                   Enfermagem 2009;22:155-61.
                                                              16.  Akhondi-Meybodi M,  Akhondi-Meybodi S,  Vakili M, Javaheri
           Patient consent                                       Z. Quality of life in patients with colorectal cancer in Iran. Arab J
                                                                 Gastroenterol 2016;17:127-30.
           At the beginning of the study, informed consent was   17.  Momeni  M, Ghanbari A, Jokar F, Rahimi A, Leyli  EK. Predictors
           obtained in written from all of the participants.     of quality of life in patients with colorectal cancer in Iran. Indian J
                                                                 Cancer 2014;51:550-6.
           Ethics approval                                    18.  Zając O, Spychała A, Murawa D, Wasiewicz J, Foltyn P, Połom K.
           The study was  conducted in accordance with the       Quality of life assessment in patients with a stoma due to rectal cancer.
           declaration of Helsinki and had ethics approval from   Rep Pract Oncol Radiother 2008;13:130-4.
           the  Tabriz University of Medical  Science Ethical   19.  Schmidt CE, Bestmann B, Küchler T, Longo WE, Kremer B. Ten-year
           Review  Committee  (Ethical  ID numbers:  TBZMED.     historic cohort of quality of life and sexuality in patients with rectal
           REC.5/4/11460).                                       cancer. Dis Colon Rectum 2005;48:483-92.
                                                              20.  Rauch  P, Miny  J, Conroy  T, Neyton  L,  Guillemin  F.  Quality  of
                                                                 life among disease-free  survivors of rectal  cancer.  J Clin Oncol
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