A phase III randomized clinical trial of laparoscopic (TLRH) or robotic radical hysterectomy (RRH) versus abdominal radical hysterectomy (ARH) in patients with early-stage cervical cancer: Preliminary quality-of-life outcomes

ObjectiveThis study aimed to compare urinary and bowel symptoms and quality of life (QoL) among women treated with a Wertheim–Meigs (WM, type III) or Wertheim–Okabayashi (WO, type IV) radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer.MethodsIn this cross-sectional observational study, patients treated with a WO or a (nerve sparing) WM radical hysterectomy (with or without adjuvant radiotherapy) between January 2000 and December 2010 in the Center for Gynaecological Oncology Amsterdam or Leiden University Medical Center were included. To assess QoL, urinary and bowel symptoms we used the EORTC QLQ-C30, EORTC QLQ-CX24, and Leiden Questionnaire. We performed a multivariate analysis to identify factors associated with urinary symptoms.ResultsTwo hundred sixty-eight women were included (152 WO and 116 WM). Quality of life was not significantly different in patients treated by WO or WM. Urinary symptoms were more often reported by patients in the WO group compared to the WM group: “feeling of urine retention” (53% vs 32%), “feeling less/no urge to void” (59% vs 14%), and “timed voiding” (49% vs 10%). With regard to bowel symptoms, there was no difference between both. Multivariate analysis showed that surgical technique was an independent factor for differences in urinary symptoms.ConclusionsPatients undergoing more radical surgery for early-stage cervical cancer report significantly more urinary dysfunction, whereas bowel function and health-related QoL are not decreased.

Download Full-text

Long-term fertility, oncological, and quality-of-life outcomes after trachelectomy in early stage cervical cancer

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-018-4972-5 ◽

2018 ◽

Vol 299 (4) ◽

pp. 1033-1041 ◽

Cited By ~ 4

Author(s):

Cecilia Malmsten ◽

Pär Hellberg ◽

Karin Bergmark ◽

Pernilla Dahm-Kähler

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Early Stage ◽

Life Outcomes ◽

Quality Of Life Outcomes ◽

Early Stage Cervical Cancer

Download Full-text

Sexual, bladder and bowel function following different minimally invasive techniques of radical hysterectomy in patients with early-stage cervical cancer

Clinical & Translational Oncology ◽

10.1007/s12094-021-02632-7 ◽

2021 ◽

Author(s):

K. Baessler ◽

S. Windemut ◽

V. Chiantera ◽

C. Köhler ◽

J. Sehouli

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Minimally Invasive ◽

Pelvic Floor ◽

Radical Hysterectomy ◽

Early Stage ◽

Bowel Function ◽

Patient Reported ◽

Early Stage Cervical Cancer

Abstract Purpose Despite the establishment of radical surgery for therapy of cervical cancer, data on quality of life and patient-reported outcomes are scarce. The aim of this retrospective cohort study was to evaluate bladder, bowel and sexual function in women who underwent minimally invasive surgery for early-stage cervical cancer. Methods From 2007–2013, 261 women underwent laparoscopically assisted radical vaginal hysterectomy (LARVH = 45), vaginally assisted laparoscopic or robotic radical hysterectomy (VALRRH = 61) or laparoscopic total mesometrial resection (TMMR = 25) and 131 of them completed the validated German version of the Australian Pelvic Floor Questionnaire (PFQ). Results were compared with controls recruited from gynecological clinics (n = 24) and with urogynecological patients (n = 63). Results Groups were similar regarding age, BMI and parity. The TMMR group had significantly shorter median follow-up (16 months versus 70 and 36 months). Postoperatively, deterioration of bladder function was reported by 70%, 57% and 44% in the LARVH, VARRVH and TMMR groups, respectively (p = 0.734). Bowel function was significantly worse after TMMR with a higher deterioration rate in 72 versus 43% (LARVH) and 47% (VARRVH) with a correspondingly higher bowel dysfunction score of 2.9 versus 1.5 and 1.8, respectively and 1.8 in urogynaecological patients. Sexual dysfunction was common in all surgical groups. 38% considered their vagina too short which was significantly associated with deep dyspareunia. Compared with controls, surgical groups had significantly increased PFQ scores. Conclusion Pelvic floor dysfunction commonly deteriorates and negatively impacts on quality of life after minimally invasive radical hysterectomy, especially bowel function after TMMR. Pelvic floor symptoms should routinely be addressed pre- and postoperatively.

Download Full-text