Audit 1

Quality and Outcomes in Global Cancer Surgery: A Prospective, International Cohort Study Evaluating Low Anterior Resection Syndrome (LARS)

Brief Background

Low anterior resection syndrome (LARS) score is a 5-item scoring tool, measuring bowel dysfunction after restorative surgery for rectal cancer. Since the original publication in 2012, the score has been validated, evaluated, or used as an outcome measure in more than 30 published scientific papers. Major LARS prevalence after total mesorectal excision differs from 55.2-74 %. It is reported that LARS significantly affects global health status estimated by EORTC-QLQ-C30 (3–5). Most surgical practices do not currently routinely evaluate defaecation function and quality of life before and after an operation and therefore there is a justifiable reason to do this on a routine basis.

ISUCRS is, therefore, conducting a 2-stage prospective international multicenter audit to evaluate low anterior resection syndrome over a 4 month period. 

Stage I – collecting local & international LARS data (patient recruitment period of 4/5 months from January 2020). Preoperative LARS & QoL data using EORTC-QLQ-C30 will be collected. After 6-12 months after reversal of stoma revaluate LARS & QoL using EORTC-QLQ-C30

After stage I, we intend to introduce accepted ISUCRS management guidelines into our clinical practice for better patient care to improve LARS and the impact on QoL.

Stage II – re-valuate the impact of these new guidelines in our clinical practice and outcomes for patients. In order to do this, we will perform a re-audit with collecting local & international LARS data (patient recruitment period of 4 months). Preoperative LARS & QoL data will be collected. After 6-12 months after reversal of stoma revaluate LARS & QoL using EORTC-QLQ-C30 (5)

Key Points

  • The principal investigators of this study will be Dr. Audrius Dulskas, Mr. Joseph Nunoo-Mensah, and Dr. Povilas Kavaliauskas. The audit is registered under King’s College Hospital, London, SE5 9RS, UK.
  • Registration to participate as an investigation center must be done via the completion of a registration form. All registered sites must have at least one investigator who is an active fellow of ISUCRS.
  • Every local investigator site must gain approval from for this audit from their own local audit boards to participate.
  • The project will be administered by ISUCRS. The publication will be authored under one main group name (ISUCRS collaborative group). All research collaborator names (a maximum of 3 from each registering site) will then be listed as authors on the publication

We would like to invite all ISUCRS members to participate by filling out the form provided below.

​For more information about this audit please see the PDF guideline here.

LARS Audit Registration Form

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