Association of chemotherapy and stoma features with peristomal skin disorders in rectal cancer patients

This study aimed to identify factors associated with the onset and worsening of peristomal skin disorders during outpatient follow-up after stoma creation for malignant rectal tumors. This prospective multicenter observational study enrolled patients who underwent stoma creation for malignant rectal tumors between December 2019 and December 2021 at six Japanese institutions. Patients were evaluated using the ABCD-Stoma and DET scoring systems at 1 month and during subsequent follow-up visits. A total of 130 patients were analyzed. At the 1-month visit, 53 (40.8%) had no peristomal skin disorders and 77 (59.2%) had lesions. Multivariate analysis showed that chemotherapy (odds ratio [OR] = 17.50, 95% confidence interval [CI]: 1.76-174.27, p = 0.015), loop stoma (OR = 43.46, 95%CI 1.70-1113.99, p = 0.023), and stoma height < 10 mm (OR = 32.68, 95%CI: 1.94-549.55, p = 0.015) were independently associated with the development of peristomal skin disorders. Diabetes mellitus (OR = 4.26, 95%CI: 1.08-16.79, p = 0.039) was independently associated with worsening, whereas stoma height < 10 mm (OR = 5.85, 95%CI: 1.16-29.35, p = 0.032) was associated with severe lesions during follow-up. These findings highlight the importance of continuous outpatient monitoring and tailored stoma-care support to facilitate early detection and management of peristomal skin disorders, especially in high-risk patients.