# Reconsidering the LARS score: a cross-sectional descriptive study exploring complementary screening approaches for low anterior resection syndrome

## TL;DR

This study compares two methods for identifying bowel dysfunction after rectal cancer surgery and finds that combining them gives a more complete picture.

## Contribution

The study explores how the International Consensus Definition complements the LARS score in identifying bowel dysfunction after rectal cancer surgery.

## Key findings

- The LARS score classified 62.9% of patients as having 'no LARS', while the International Consensus Definition identified 38.7% as meeting LARS criteria.
- Nine patients were classified differently by the two tools, highlighting discrepancies in symptom impact assessment.
- Combining both tools may provide a more comprehensive evaluation of LARS until multidimensional instruments are available.

## Abstract

The LARS score is a practical tool to screen for bowel dysfunction after rectal cancer surgery. However, clinical experience suggests that it may overlook relevant symptoms and/or overestimate impact in some patients. This study aimed to explore whether the International Consensus Definition of LARS complements the LARS score in identifying patients with bowel dysfunction.

We conducted a cross-sectional study including patients treated for rectal cancer across two hospitals between January 2021 and December 2024. Demographic and clinical data were collected retrospectively. Functional outcomes were assessed during outpatient follow-up using both the LARS score and the International Consensus Definition criteria.

Sixty-two patients were included. According to the LARS score, 39 (62.9%) had “no LARS”, 10 (16.1%) “minor LARS” and 13 (21%) “major LARS”. Using the International Consensus Definition, 24 (38.7%) met the criteria for LARS. Nine patients (14.5%) were classified differently by the two tools. Five patients classified as “no LARS” by the LARS score met the International Consensus Definition due to unpredictable bowel function and emptying difficulties with a reported impact on daily life. In contrast, four patients with “minor or major LARS” did not meet the International Consensus Definition criteria because no consequences were reported.

In this exploratory cross-sectional cohort, the International Consensus Definition did not identify substantially more patients than the LARS score but provided complementary information by linking symptoms to their perceived consequences. Combining both tools may offer a more comprehensive appraisal of LARS until newer multidimensional instruments become available.