Assessment of Quality of Life and Urinary and Sexual Function After Radical Hysterectomy in Long-Term Cervical Cancer Survivors

2018 ◽  
Vol 28 (4) ◽  
pp. 818-823 ◽  
Author(s):  
Francesco Plotti ◽  
Corrado Terranova ◽  
Stella Capriglione ◽  
Stefania Crispino ◽  
Alessandra Li Pomi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Sexual Function ◽  
Sexual Activity ◽  
Radical Hysterectomy ◽  
European Organization ◽  
Type Iii

AimsThe aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III.MethodsAll patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up. Included subjects were interviewed with the European Organization for Research and Treatment of Cancer QLQ-CX24 Questionnaire, European Organization for Research and Treatment of Cancer QLQ-C30, and an Incontinence Impact Questionnaire 7.ResultsFrom January 2004 to June 2014, 251 patients affected by locally advanced cervical cancer were treated at Campus Bio-Medico of Rome treated with type C2/type III RH. At time point of March 2017, 90 patients were included with a mean age of 55.6 ± 8.5 years. The questionnaires were administered after a median follow-up of 49 months after the end of therapy. The symptoms of fatigue, nausea and vomiting, appetite loss, pain, insomnia, and dyspnea, as well as a negative financial impact, were reported as not frequent and rarely disabling. On the contrary, patients frequently reported gastrointestinal complaints. Diarrhea was present in 6% of patients and was referred as mild; constipation was present in 75% of women and was reported as mild in 30% of cases, moderate in 30%, and severe in 15%. Concerning sexual activity, data indicated a good level of sexual enjoyment with a slight worsening of sexual activity. Incontinence was reported in 28% of cases and appeared to be mild and rarely disabling (all mean values <2).ConclusionsWaiting for ongoing randomized controlled trials, this study confirmed that RH may be considered as a useful treatment plan, according to its negligible long-term impact on quality of life, urinary dysfunction, and sexual function.

Long-term androgen deprivation therapy (ADT) with leuprorelin and quality of life in patients with advanced prostate cancer (PCa).

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 268-268
Author(s):  
Peter Hammerer ◽  
Lukas Manka ◽  
Manfred Wirth
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Sexual Activity ◽  
Androgen Deprivation ◽  
Term Therapy ◽  
Control Group ◽  
Long Term Treatment ◽  
Hormone Sensitive

268 Background: LHRH analogs are the gold standard for treatment of patients with hormone-sensitive advanced PCa. In this study, we investigated the quality of life (QoL) of PCa patients under long-term treatment with leuprorelin acetate in microcapsules (1, 3, and 6 month depot formulation) for up to 19.8 years. Methods: Observational and retrospective analysis of data from 536 PCa patients treated with leuproreline and 116 patients of a control group (CG, ≥ 77 years of age, > 5 years urological treatment, no cancer, no ADT). Data was collected in 30 German office based urological practices using EORTC questionnaires QLQ-C30 and QLQ-PR25. Results: Mean treatment duration was 8.6 years (range: 4.5 - 19.8 years). Mean age ± SD of PCa patients (79.6 ± 6.3 years) was comparable to CG (80.5 ± 3.1 years), as were body height, weight, BMI, and Karnofsky-Index (88.0 ± 12.7 vs. 88.4 ± 12.0). The general health status (QLQ-C30) was comparable for PCa patients vs. CG: 64.6 ± 20.5 vs. 66.8 ± 20.3; p = 0.3117. Marginal differences were observed regarding physical functioning (73.2 ± 23.1 vs. 78.1 ± 21.0; p = 0.0402) and role functioning (70.6 ± 30.4 vs. 74.4 ± 25.7; p = 0.1648). PCa patients rated fatigue (33.6 ± 25.1 vs. 28.8 ± 23.3; p = 0.0629), dyspnoea (24.0 ± 28.5 vs. 19.6 ± 26.9; p = 0.1307), and insomnia (28.9 ± 32.6 vs. 23.7 ± 27.2; p = 0.0751) slightly worse than CG. As assessed by QLQ-PR25, PCa patients scored lower on sexual activity (12.0 ± 20.6 vs. 23.7 ± 25.7; p < 0.0001) and sexual function (43.3 ± 25.8 vs. 55.9 ± 27.0; p = 0.0067) compared to CG. PCa patients had less urinary tract symptoms (28.2 ± 19.8 vs. 31.2 ± 19.2; p = 0.1472) but stronger symptoms of androgen deprivation (21.4 ± 17.3 vs. 10.8 ± 13.2; p < 0.0001), and they had a higher need of incontinence aids (29.6 ± 34.2 vs. 16.7 ± 20.5; p = 0.0056) – however, 136 of the 536 PCa patients had a prostatectomy. Conclusions: In this study, PCa patients treated with leuprorelin for up to 19.8 years (8.6 years on average) had an overall QoL comparable to an age-matched control group. As expected, sexual activity and sexual function were lower in PCa patients under ADT. Overall, treatment with leuprorelin is a well-tolerated long-term therapy for patients with hormone-sensitive advanced PCa. Clinical trial information: ENA E005(a) / DE-N-LEU-019(a).

Long-term follow-up after cystectomy for bladder pain syndrome: Pain status, sexual function and quality of life

2019 ◽  
Vol 18 (1) ◽  
pp. e1977
Author(s):  
L. Mateu Arrom ◽  
C. Gutierrez Ruiz ◽  
O. Mayordomo ◽  
V. Martínez ◽  
J. Palou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Status ◽  
Long Term Follow Up

scholarly journals The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 317
Author(s):  
Mihai Stanca ◽  
Dan Mihai Căpîlna ◽  
Cristian Trâmbițaș ◽  
Mihai Emil Căpîlna
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Cancer Survivors ◽  
Radical Hysterectomy ◽  
Gynecological Cancer ◽  
Sexual Life ◽  
Eastern European ◽  
Cox Regression Analysis

(1) Background: Cervical cancer patients have been found to have worse quality of life (QoL) scores due to cancer treatment, not only when compared to the general population, but also when compared to other gynecological cancer survivors. In Eastern European developing countries, the health care system often cannot afford the uppermost standardized treatment for these patients. In the absence of a comparable study in our country, the authors’ aim for this retrospective cross-sectional observational study was to evaluate the overall survival (OS) and the QoL o cervical cancer survivors; (2) Methods: 430 patients were analyzed. The first objective is to evaluate the OS rates of patients with cervical cancer stages IA2 to IIB undergoing radical hysterectomy (RH) +/− neoadjuvant or adjuvant radiotherapy +/− chemoradiotherapy treatment combinations. The second objective is to assess their QoL, using two standardized questionnaires issued by the European Organisation for Research and Treatment of Cancer (EORTC), namely QLQ-C30 and QLQ-CX24. (3) Results: The mean age of the participants was 51 years (22–76) and the average follow-up time was 65 months (2–128). At the time of the analysis, 308 out of 430 patients were alive, with a mean five-year OS of 72.4%. The multivariate Cox regression analysis identified stage IIB, parametrial invasion, and the lymph node metastases as independent prognostic risk factors negatively impacting the OS. Of the 308 patients still alive at the time of the analysis, 208 (68%) answered the QoL questionnaires. The QLQ-C30 shows a good long-term Global QoL of 64.6 (median), good functioning scores, and a decent symptom scale value. However, the EORTC QLQ-CX24 showed high values of cervical cancer-specific symptoms, namely: lymphedema, peripheral neuropathy, severe menopausal symptoms, and distorted body-image perception. The results also indicate a significant decline in the quality of sexual life with a low sexual enjoyment and decreased level of sexual activities. (4) Conclusion: Despite a good OS, in this setting of patients, cervical cancer survivors have a modest QoL and sexual function. Our study may provide a comparison for future randomized, controlled trials in Eastern European countries needing to confirm these results.

Long-Term Morbidity and Quality of Life in Cervical Cancer Survivors: A Multicenter Comparison Between Surgery and Radiotherapy as Primary Treatment

2017 ◽  
Vol 27 (2) ◽  
pp. 350-356 ◽  
Author(s):  
Marloes Derks ◽  
Luc R.C.W. van Lonkhuijzen ◽  
Rinske M. Bakker ◽  
Anne M. Stiggelbout ◽  
Cornelis D. de Kroon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Global Health ◽  
Social Functioning ◽  
Subgroup Analysis ◽  
Adjuvant Radiotherapy ◽  
Primary Treatment ◽  
European Organization

ObjectiveTo compare long-term morbidity and quality of life after primary surgery or primary radiotherapy for stage IB/II cervical cancer.MethodsA cross-sectional study was performed. Patients treated for stage IB/II cervical cancer between 2000 and 2010 were approached to participate. Primary treatment consisted of radical hysterectomy with pelvic lymphadenectomy (RHL), for selected cases followed by adjuvant (chemo-)radiotherapy, or primary (chemo)radiotherapy (PRT). European Organization for Research and Treatment of Cancer-C30 and European Organization for Research and Treatment of Cancer-CX24 questionnaires were administered. A multivariable analysis was performed to identify factors associated with morbidity/quality of life. In a subgroup analysis, we compared patients with RHL + adjuvant radiotherapy with those after PRT.ResultsThree hundred twenty-three cervical cancer survivors were included (263 RHL/60 PRT). In the PRT group, International Federation of Gynecology and Obstetrics stage was higher and women were older. In the RHL group, more women had a partner. Women treated with PRT reported lower physical (β, −6.01) and social functioning (β, −15.2), more financial problems (β, 10.9), diarrhea (β, 9.98), symptom experience (β, 6.13), sexual worry (β, 11.3), and worse sexual/vaginal functioning (β, 11.4). Women treated with RHL reported significantly more lymphedema (β, −16.1). No differences in global health were found. In the subgroup analysis, women after PRT (n = 60) reported poorer social functioning, less sexual enjoyment, and higher symptoms experience than women after RHL and adjuvant radiotherapy (n = 60). The latter reported more lymphedema.ConclusionsAlthough global health scores are not significantly different, women after PRT report more physical, social, and sexual symptoms. These results can be well used by physicians to inform their patients about treatment-related morbidity.

Quality of life and sexual functioning after cervical cancer treatment: a long-term follow-up study

2009 ◽  
Vol 18 (5) ◽  
pp. 476-482 ◽  
Author(s):  
Elfriede R. Greimel ◽  
Raimund Winter ◽  
Karin S. Kapp ◽  
Josef Haas
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Cancer Treatment ◽  
Sexual Functioning ◽  
Follow Up Study ◽  
Long Term Follow Up

Lymphedema and bladder-emptying difficulties after radical hysterectomy for early cervical cancer and among population controls

2006 ◽  
Vol 16 (3) ◽  
pp. 1130-1139 ◽  
Author(s):  
K. Bergmark ◽  
E. ÅVALL-LUNDQVIST ◽  
P. W. Dickman ◽  
L. Henningsohn ◽  
G. Steineck
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Fold Increase ◽  
Outcome Data ◽  
Improve Quality ◽  
Bladder Emptying ◽  
Population Controls

The aim of the study was to acquire knowledge that can be used to refine radical hysterectomy to improve quality-of-life outcome. Data were collected in 1996–1997 by means of an anonymous postal questionnaire in a follow-up study of two cohorts (patients and population controls). We attempted to enroll all 332 patients with stage IB–IIA cervical cancer registered in 1991–1992 at the seven departments of gynecological oncology in Sweden and 489 population controls. Ninety three (37%) of the 256 women with a history of cervical cancer who answered the questionnaire (77%) were treated with surgery alone. Three-hundred fifty population controls answered the questionnaire (72%). Women treated with radical hysterectomy, as compared with controls, had an 8-fold increase in symptoms indicating lymphedema (25% reported distress due to lymphedema), a nearly 9-fold increase in difficult emptying of the bladder, and a 22-fold increase in the need to strain to initiate bladder evacuation. Ninety percent of the patients were not willing to trade off survival for freedom from symptoms. Avoiding to induce long-term lymphedema or bladder-emptying difficulties would probably improve quality of life after radical hysterectomy (to cure cervical cancer). Few women want to compromise survival to avoid long-term symptoms.

Long-term quality of life after peroral endoscopic myotomy remains compromised in patients with achalasia type III

Endoscopy ◽  
2017 ◽  
Vol 49 (12) ◽  
pp. 1209-1218 ◽  
Author(s):  
Oscar Hernández Mondragón ◽  
Marina González Martinez ◽  
Juan Blancas Valencia ◽  
Maria Hernandez Reyes ◽  
Omar Solórzano Pineda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Logistic Regression Analysis ◽  
Peroral Endoscopic Myotomy ◽  
Type Iii ◽  
Eckardt Score ◽  
Endoscopic Myotomy ◽  
Type Iii Achalasia

Abstract Background and study aims Peroral endoscopic myotomy (POEM) is an excellent endoscopic treatment for achalasia. Clinical and manometric parameters are used for evaluation and follow-up. However, clinical success does not guarantee high quality of life (QoL) scores, generating doubts about their direct relationship. We aimed to evaluate QoL scores before and after POEM at medium and long term, to evaluate differences between achalasia subtypes and find which factors related to low QoL scores. Patients and methods Achalasia-confirmed patients undergoing POEM between February 2012 and November 2016. and completing at least 1 year of follow-up, were included. Assessment before and at 1, 6, 12, 24, 36 and 48 months after POEM employed manometry, barium series, Eckardt score, and the AE-18 health-related QoL scale. Demographic, clinical, and procedure characteristics were documented, with comparisons between subgroups. Multiple logistic regression analysis was done. Results 65 of 88 patients were included (38 women, 27 men; median age 47 years, interquartile range [IQR] 20 – 81), and 50 (76.9 %) completed 4 years of follow-up. Eckardt score improved (median, preprocedure 10 vs. post-procedure 2; P = 0.002) and this persisted. There was initial improvement in median integrated relaxation pressure (IRP) (29.4 mmHg [16 – 55] vs. 10.3 mmHg [3 – 18]; P = 0.000) and median QoL scores (40 vs. 68 at 1 month; P = 0.002); however IRP increased and QoL scores decreased. Men with confirmed type III achalasia had low QoL scores. Conclusions All patients had significant clinical improvement after POEM, with medium- to long-term persistence. Though quality of life and IRP initially improved, they deteriorated in the long term. Male sex and type III achalasia seem to be associated with low QoL scores.

Long-term follow-up after cystectomy for bladder pain syndrome: pain status, sexual function and quality of life

2018 ◽  
Vol 37 (8) ◽  
pp. 1597-1603 ◽  
Author(s):  
Laura Mateu Arrom ◽  
Cristina Gutiérrez Ruiz ◽  
Olga Mayordomo Ferrer ◽  
Virginia Martínez Barea ◽  
Joan Palou Redorta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Function ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Bladder Pain ◽  
Pain Status ◽  
Long Term Follow Up
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