Quality of Life Is Impaired in Anemic MDS Patients, and May Still Remain Poor Even When Hemoglobin Improves

Abstract Background: Quality of life (QoL) is impaired in MDS. Aims: 1) To study QoL for various levels of anemia in MDS patients at diagnosis, 2) Compare with non-MDS controls. 3) Compare at MDS diagnosis to 1 year later. Methods: Patients in The Israel MDS registry fill out the EQ-5D QoL questionnaire. The evaluated parameters are: mobility, self-care, daily activities, pain/discomfort and anxiety/depression, each scored 0(normal), 1(mild/moderate), or 2(poor). They also evaluate their general health using a visual analogue scale (VAS), scoring from 0 (poor) to 100(excellent). Anemia was classified as none/normal (Hb≥12.5 g/dl), mild (10≤Hb<12.5), moderate (9≤Hb<10), severe (8≤Hb<9) or very severe (Hb<8). To assess QoL dynamics, MDS patients repeat this every 6 months . For controls, we used VAS to assess QoL of patients admitted to the Department of Medicine. Results: In total, 126 MDS patients participated: 19, 40, 17, 21 and 29, from normal to very severe anemia, respectively. Fig.1 shows mean QoL of the 5-parameters for all patients (A), and for each individual (B), as well as the mean VAS score for all patients (C) and for each individual (D). Anemic MDS patients show a wide QoL variability (patients with the same Hb behave differently, Fig.1, B, D). Also, note the drop in QoL from moderate to severe anemia (below 9 g/dl, p=0.06, for 5-parameter; p=0.01, for VAS). In the non-MDS controls (n=141), there was impaired QoL in anemic patients as compared to those without anemia (VAS, Figure 2; p=0.02). However, there was no significant difference in QoL among patients with various degrees of anemia. Follow-up QoL data (1 year) were available for 61 MDS patients (Figure 3). 27 (44%) increased Hb. 32 (52%) decreased, and 2 (3%), had no change. Of the 32 who decreased Hb, average QoL deteriorated by -11.88 [95%CI: -17.96, -5.79]; 24 patients (75%, Figure 3, left-lower quadrant) had decreased VAS score; some still had improved QoL (16%), or stayed the same (9%). Of the 27 who increased Hb, average VAS still reduced by -6.48 [-14.08, 1.12]. The minority increased QoL (26%), or stayed the same (19%). Most (56%) still deteriorated in QoL (right-lower). The QoL results using the 5 parameters was consistent. Conclusions: In this preliminary study: 1) Poor QoL in anemic MDS is variable and not linear, suggesting that other factors, in addition to Hb, affect QoL. 2) The sharp drop in QoL with Hb<9 g/dl (Figure 1, A and C from blue to pink), might lead to a therapeutic paradigm shift, with transfusion recommendations for patients with Hb<9. 3) QoL in anemic MDS patients might differ from non-MDS. 4) Anemia treatment and Hb rise are not necessarily associated with improved QoL. Larger studies will help determine QoL in MDS and other anemias and when and how to treat. Figure 1 Figure 1. Disclosures Mittelman: Janssen · Roche · Novartis · Takeda · Medison / Amgen · Neopharm / Celgene / BMS · Abbvie · Gilead: Research Funding; Novartis · Takeda · Fibrogen · Celgene / BMS · Onconova · Geron: Other: Clini; Onconova · Novartis · Takeda · Silence: Membership on an entity's Board of Directors or advisory committees; MDS HUB: Consultancy; Celgene / BMS · Novartis: Speakers Bureau.

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Colorectal resection in endometriosis patients: correlation between histopathological findings and postoperative outcome

European Journal of Medical Research ◽

10.1186/s40001-021-00484-z ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Peter Tschann ◽

Nikola Vitlarov ◽

Martin Hufschmidt ◽

Daniel Lechner ◽

Paolo N. C. Girotti ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Resection ◽

Postoperative Outcome ◽

Resection Margins ◽

Pain Level ◽

Histopathological Findings ◽

Vas Score ◽

Reduction Of Pain

Abstract Introduction Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. Methods Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. Results Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54). Conclusion Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.

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Breast reconstruction after breast cancer surgery – persistent pain and quality of life 1–8 years after breast reconstruction

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0026 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Nina Honkanen ◽

Laura Mustonen ◽

Eija Kalso ◽

Tuomo Meretoja ◽

Hanna Harno

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Reconstruction ◽

Perforator Flap ◽

Persistent Pain ◽

Rectus Abdominis ◽

Preoperative Pain ◽

Significant Difference

Abstract Objectives To assess the long-term outcome of breast reconstructions with special focus on chronic postsurgical pain (CPSP) in a larger cohort of breast cancer survivors. Methods A cross-sectional study on 121 women with mastectomy and breast reconstruction after mean 2 years 4 months follow up. The mean time from breast reconstruction to the follow-up visit was 4 years 2 months. We studied surveys on pain (Brief Pain Inventory, BPI and Douleur Neuropathique 4, DN4), quality of life (RAND-36 health survey), sleep (insomnia severity questionnaire, ISI), mood (Beck’s Depression Index, BDI; Hospital Anxiety and Depression Scale, HADS), and a detailed clinical sensory status. Patients were divided into three groups: abdominal flap (Deep inferior epigastric perforator flap, DIEP; Free transverse rectus abdominis flap, fTRAM, and Pedicled transverse rectus abdominis flap, pTRAM), dorsal flap (Latissimus dorsi flap, LD and Thoracodorsal artery perforator flap, TDAP), and other (Transverse myocutaneous gracilis flap, TMG; implant). Clinically meaningful pain was defined ≥ 4/10 on a numeric rating scale (NRS). We used patients’ pain drawings to localize the pain. We assessed preoperative pain NRS from previous data. Results 106 (87.6%) of the patients did not have clinically meaningful persistent pain. We found no statistically significant difference between different reconstruction types with regards to persistent pain (p=0.40), mood (BDI-II, p=0.41 and HADS A, p=0.54) or sleep (p=0.14), respectively. Preoperative pain prior to breast reconstruction surgery correlated strongly with moderate or severe CPSP. Conclusions Moderate to severe CPSP intensity was present in 14% of patients. We found no significant difference in the prevalence of pain across different reconstruction types. Preoperative pain associated significantly with postoperative persistent pain.

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Comparative Analysis of Patients with Robotic Hiatal Hernia Repairs with and without Collis Gastroplasty

The American Surgeon ◽

10.1177/0003134821989051 ◽

2021 ◽

pp. 000313482198905

Author(s):

John A. Perrone ◽

Stephanie Yee ◽

Manrique Guerrero ◽

Antai Wang ◽

Brian Hanley ◽

...

Keyword(s):

Quality Of Life ◽

Statistical Analysis ◽

Hospital Stay ◽

Hiatal Hernia ◽

Collis Gastroplasty ◽

Significant Difference ◽

Related Quality

Introduction After extensive mediastinal dissection fails to achieve adequate intra-abdominal esophageal length, a Collis gastroplasty(CG) is recommended to decrease axial tension and reduce hiatal hernia recurrence. However, concerns exist about staple line leak, and long-term symptoms of heartburn and dysphagia due to the acid-producing neoesophagus which lacks peristaltic activity. This study aimed to assess long-term satisfaction and GERD-related quality of life after robotic fundoplication with CG (wedge fundectomy technique) and to compare outcomes to patients who underwent fundoplication without CG. Outcomes studied included patient satisfaction, resumption of proton pump inhibitors (PPI), length of surgery (LOS), hospital stay, and reintervention. Methods This was a single-center retrospective analysis of patients from January 2017 through December 2018 undergoing elective robotic hiatal hernia repair and fundoplication. 61 patients were contacted for follow-up, of which 20 responded. Of those 20 patients, 7 had a CG performed during surgery while 13 did not. There was no significant difference in size and type of hiatal hernias in the 2 groups. These patients agreed to give their feedback via a GERD health-related quality of life (GERD HRQL) questionnaire. Their medical records were reviewed for LOS, length of hospital stay (LOH), and reintervention needed. Statistical analysis was performed using SPSS v 25. Satisfaction and need for PPIs were compared between the treatment and control groups using the chi-square test of independence. Results Statistical analysis showed that satisfaction with outcome and PPI resumption was not significantly different between both groups ( P > .05). There was a significant difference in the average ranks between the 2 groups for the question on postoperative dysphagia on the follow-up GERD HRQL questionnaire, with the group with CG reporting no dysphagia. There were no significant differences in the average ranks between the 2 groups for the remaining 15 questions ( P > .05). The median LOS was longer in patients who had a CG compared to patients who did not (250 vs. 148 min) ( P = .01). The LOH stay was not significantly different ( P > .05) with a median length of stay of 2 days observed in both groups. There were no leaks in the Collis group and no reoperations, conversions, or blood transfusions needed in either group. Conclusion Collis gastroplasty is a safe option to utilize for short esophagus noted despite extensive mediastinal mobilization and does not adversely affect the LOH stay, need for reoperation, or patient long-term satisfaction.

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Z-score neurofeedback, heart rate variability biofeedback, and brain coaching for older adults with memory concerns

Restorative Neurology and Neuroscience ◽

10.3233/rnn-201053 ◽

2020 ◽

pp. 1-29

Author(s):

Kyle D. Meeuwsen ◽

Kayleah M. Groeneveld ◽

Linda A. Walker ◽

Anna M. Mennenga ◽

Rachel K. Tittle ◽

...

Keyword(s):

Quality Of Life ◽

Boot Camp ◽

Relative Power ◽

Z Score ◽

Subjective Memory Complaints ◽

Subjective Memory ◽

Memory Complaints ◽

Anxiety Depression

Background: The three-month, multidomain Memory Boot Camp program incorporates z-score neurofeedback (NFB), heart rate variability (HRV) biofeedback, and one-on-one coaching to teach memory skills and encourage behavior change in diet, sleep, physical fitness, and stress reduction. Objective: This prospective trial evaluates the Memory Boot Camp program for adults ages 55 to 85 with symptoms of Mild Cognitive Impairment (MCI) and subjective memory complaints. Methods: Participants were evaluated via the Montreal Cognitive Assessment (MoCA), NeuroTrax Global Cognitive Index, measures of anxiety, depression, sleep, quality of life, quantitative electroencephalography (QEEG), and HRV parameters at four timepoints: baseline, pre-program, post-program, and follow-up. The trial included a three-month waiting period between baseline and pre-program, such that each participant acted as their own control, and follow-up took place six months after completion of the program. Results: Participants’ MoCA scores and self-reported measures of anxiety, depression, sleep quality, and quality of life improved after treatment, and these changes were maintained at follow-up. Physiological changes in HRV parameters after treatment were not significant, however, breathing rate and QEEG parameters were improved at post-program and maintained at follow-up. Finally, participants’ improvement in MoCA score over the treatment period was correlated with their improvement in two brain oscillation parameters targeted by the z-score NFB protocol: relative power of delta and relative power of theta. Conclusions: Trial results suggest that the Memory Boot Camp program is a promising treatment strategy for older adults with symptoms of MCI and subjective memory complaints.

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Quality of Life Following Urgent LVAD Implantation for ECMO Therapy in Cardiogenic Shock: A Long-Term Follow-Up

Medicina ◽

10.3390/medicina57080747 ◽

2021 ◽

Vol 57 (8) ◽

pp. 747

Author(s):

Rafal Berger ◽

Hasan Hamdoun ◽

Rodrigo Sandoval Boburg ◽

Medhat Radwan ◽

Metesh Acharya ◽

...

Keyword(s):

Quality Of Life ◽

Cardiogenic Shock ◽

Left Ventricular ◽

Ecmo Support ◽

Circulatory Support ◽

Significant Difference ◽

Va Ecmo ◽

Ecmo Therapy

Background and Objectives: Over the past decade, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has developed into a mainstream treatment for refractory cardiogenic shock (CS) to maximal conservative management. Successful weaning of VA-ECMO may not be possible, and bridging with further mechanical circulatory support (MCS), such as urgent implantation of a left ventricular assist device (LVAD), may represent the only means to sustain the patient haemodynamically. In the recovery phase, many survivors are not suitably prepared physically or psychologically for the novel issues encountered during daily life with an LVAD. Materials and Methods: A retrospective analysis of our institutional database between 2012 and 2019 was performed to identify patients treated with VA-ECMO for CS who underwent urgent LVAD implantation whilst on MCS. Post-cardiotomy cases were excluded. QoL was assessed prospectively during a routine follow-up visit using the EuroQol-5 dimensions-5 level (EQ-5D-5L) and the Patient Health Questionnaire (PHQ-9) surveys. Results: Among 126 in-hospital survivors of VA-ECMO therapy due to cardiogenic shock without prior cardiac surgery, 31 (24.6%) urgent LVAD recipients were identified. In 11 (36.7%) cases, cardiopulmonary resuscitation (CPR) was performed (median 10, range 1–60 min) before initiation of VA-ECMO, and in 5 (16.7%) cases, MCS was established under CPR. Mean age at LVAD implantation was 51.7 (+/−14) years and surgery was performed after a mean 12.1 (+/−8) days of VA-ECMO support. During follow-up of 46.9 (+/−25.5) months, there were 10 deaths after 20.4 (+/−12.1) months of LVAD support. Analysis of QoL questionnaires returned a mean EQ-5D-5L score of 66% (+/−21) of societal valuation for Germany and a mean PHQ-9 score of 5.7 (+/−5) corresponding to mild depression severity. When compared with 49 elective LVAD recipients without prior VA-ECMO therapy, there was no significant difference in QoL results. Conclusions: Patients requiring urgent LVAD implantation under VA-ECMO support due to CS are associated with comparable quality of life without a significant difference from elective LVAD recipients. Close follow-up is required to oversee patient rehabilitation after successful initial treatment.

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Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽

10.1007/s10029-021-02453-1 ◽

2021 ◽

Author(s):

M. M. J. Van Rooijen ◽

T. Tollens ◽

L. N. Jørgensen ◽

T. S. de Vries Reilingh ◽

G. Piessen ◽

...

Keyword(s):

Quality Of Life ◽

Hernia Repair ◽

Hernia Recurrence ◽

Recurrence Rates ◽

Elective Repair ◽

Significant Difference ◽

Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

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Abstract TP295: Stroke Prevention Surgery > Quality of Life and Cognitive Ability to Drive Are Maintained After Surgical Repair of Unruptured Intracranial Aneurysm

Stroke ◽

10.1161/str.51.suppl_1.tp295 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Joan M ODonnell ◽

Maurizio Manuguerra ◽

Jemma L Hodge ◽

Greg Savage ◽

Michael K Morgan

Keyword(s):

Quality Of Life ◽

Intracranial Aneurysm ◽

Surgical Management ◽

Cognitive Abilities ◽

Short Form ◽

Unruptured Intracranial Aneurysm ◽

Significant Difference ◽

Ability To Drive

Background: Studies have questioned the effectiveness of surgery for the management of unruptured intracranial aneurysm (uIA). Few studies have examined the ability to drive and quality of life (QOL) after surgery for uIA. Objective: This study examined the effectiveness of surgical management of uIA by measuring patients’ perceived quality of life and their cognitive abilities related to driving. Methods: Between January 2011 and January 2016 patients with a uIA were assessed using the Quality Metric Short Form 36 (SF36) and the off-road driver screening instrument DriveSafeDriveAware. Reassessments were conducted at the 6-week post-operative follow-up for surgical patients and at 12-month follow-up for surgical and conservatively managed patients. Results: 175 patients enrolled in the study, of which 112(66%) had surgical management of their aneurysm. For the surgical cases who completed all assessments (N=74), there was a trend for the DriveSafe pre-operative mean score of 108 (SD 10.7) to be lower than the 6-week and 12-month post-operative mean scores (111 SD 9.7 and 112 SD 10.2 respectively)(p=0.05). There were no significant changes in DriveAware scores at any epoch or between patient groups nor in the MCS in the surgical group.. There was a significant decline in PCS scores at 6 weeks post-operatively which recovered at 12 months (52 SD 8.1, 46 SD 6.8 and 52 SD 7.1 respectively)( p <0.01). There was no significant difference in 12-month mRS scores between the surgical cases who completed with cases who did not complete all assessments. Conclusion: Surgery for uIA did not affect cognitive abilities for driving at 6 weeks or 12 months after surgery. There was a decline in the QOL in the first months after surgery, however QOL returned to pre-surgical status 12 months after surgery. If the risk of seizures is low and there are no post-operative complications, returning to driving can be recommended.

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Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with de-novo Oligometastatic Prostate Cancer

Cancers ◽

10.3390/cancers13225636 ◽

2021 ◽

Vol 13 (22) ◽

pp. 5636

Author(s):

Michael Chaloupka ◽

Lina Stoermer ◽

Maria Apfelbeck ◽

Alexander Buchner ◽

Vera Wenter ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Radical Prostatectomy ◽

De Novo ◽

Health Related Quality ◽

Significant Difference ◽

Related Quality ◽

Health Related

(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (n = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (n = 79 with oligo-metastatic bone disease (cM1-oligo) and n = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, p = 0.186), and at time of follow-up (44% vs. 56%, p = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, p = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, p = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, p = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, p = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, p = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.

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Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.109 ◽

2021 ◽

Vol 8 (4) ◽

pp. 492-500

Author(s):

Manish Kumar Singh ◽

Pragya Verma ◽

Sarita Singh ◽

Gyan P Singh ◽

Hemlata Verma

Keyword(s):

Quality Of Life ◽

Morphine Consumption ◽

Rescue Analgesia ◽

Vas Score ◽

Group I ◽

Significant Difference ◽

The Mean ◽

Group Ii ◽

Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

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Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India

Quality of Life Research ◽

10.1007/s11136-019-02351-1 ◽

2019 ◽

Vol 29 (3) ◽

pp. 683-692

Author(s):

K. V. Deepa ◽

A. Gadgil ◽

Jenny Löfgren ◽

S. Mehare ◽

Prashant Bhandarkar ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Breast Conservation ◽

Radical Mastectomy ◽

Breast Conservation Surgery ◽

Breast Cancer Surgery ◽

Significant Difference ◽

Domain Scores

Abstract Purpose Breast cancer is the commonest cancer in women worldwide. Surgery is a central part of the treatment. Modified radical mastectomy (MRM) is often replaced by breast conserving therapy (BCT) in high-income countries. MRM is still the standard choice, in low- and middle-income countries (LMICs) as radiotherapy, a mandatory component of BCT is not widely available. It is important to understand whether quality of life (QOL) after MRM is comparable to that after BCT. This has not been studied well in LMICs. We present, 5-year follow-up of QOL scores in breast cancer patients from India. Methods We interviewed women undergoing breast cancer surgery preoperatively, at 6 months after surgery, and at 1 year and 5 years, postoperatively. QOL scores were evaluated using FACT B questionnaire. Average QOL scores of women undergoing BCT were compared with those undergoing MRM. Total scores, domain scores and trends of scores over time were analyzed. Results We interviewed 54 women with a mean age of 53 years (SD 9 ± years). QOL scores in all the women, dipped during the treatment period, in all subscales but improved thereafter and even surpassed the baseline in physical, emotional and breast-specific domains (p < 0.05) at 5 years. At the end of 5 years, there was no statistically significant difference between the MRM and BCT groups in any of the total or domain scores. Conclusion QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.

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