Outcomes of palliative surgery in metastatic disease of the cervical and cervicothoracic spine

2011 ◽  
Vol 14 (5) ◽  
pp. 612-618 ◽  
Author(s):  
Gerald M. Quan ◽  
Jean-Marc Vital ◽  
Vincent Pointillart
Keyword(s):  
Quality Of Life ◽  
Social Role ◽  
Radicular Pain ◽  
Palliative Surgery ◽  
Combined Approach ◽  
European Organization ◽  
Early Postoperative Complications ◽  
Urinary Sphincter

Object This prospective study was undertaken to assess the clinical outcome of 26 consecutive patients who underwent surgery for symptomatic metastases of the cervical or cervicothoracic spine. Methods All patients suffered axial or radicular pain, with or without neurological deficit, including radicular weakness (23%), quadriplegia or paraplegia (12%), and urinary sphincter dysfunction (8%). All patients underwent palliative decompression and stabilization surgery via an anterior (18 patients), posterior (7 patients) or combined approach (1 patient) depending on the topography of the metastases, and were prospectively followed up for 1 year. Thirteen patients received adjuvant chemotherapy and 7 patients received radiotherapy to the cervical lesion. Clinical data as well as data from the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire were obtained pre- and postoperatively and at regular follow-up intervals. Results Median survival was 6 months and 10 patients were known survivors at 12 months. Postoperatively, 1 patient developed neurological deterioration and died while an inpatient. There were no other early postoperative complications in any patients. From pre- to postoperatively there was an immediate and significant improvement in axial and radicular pain and overall quality of life. There was also overall improvement in cognitive, emotional, social, role, and physical functioning. The observed improvement in pain, functioning, and quality of life was maintained for the duration of the follow-up period. Furthermore, neurological function was improved or preserved until death in the majority of patients. Conclusions Together with adjuvant medical management, surgery for cervical metastases produces low morbidity and can achieve good symptomatic palliation in the majority of patients for their remaining lifetime.

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.

Prospective Assessment of Quality of Life and Psychological Distress in Patients With Gynecologic Malignancy: A 1-Year Prospective Study

2012 ◽  
Vol 22 (6) ◽  
pp. 1096-1101 ◽  
Author(s):  
Guler Yavas ◽  
Nasuh Utku Dogan ◽  
Cagdas Yavas ◽  
Nilgun Benzer ◽  
Deniz Yuce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Anxiety And Depression ◽  
Life Questionnaire ◽  
Gynecologic Malignancy ◽  
European Organization ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

ObjectiveOur aim was to evaluate the health-related quality of life (HRQoL) and psychological distress in patients treated with radiotherapy (RT) for gynecologic malignancy.MethodsFifty-seven women with either cervical or endometrial cancer were prospectively enrolled. We assessed HRQoL at baseline (after surgery before RT), at the end of RT, and during follow-up (every 3 months thereafter) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cervical Cancer Quality of Life Questionnaire 24 (EORTC QLQ-CX24), and Hospital Anxiety and Depression Scale.ResultsWe demonstrated changes in appetite loss (P= 0.03), nausea and vomiting (P= 0.02), and role function score (P= 0.003) domains of EORTC QLQ-C30. Only the mean body image score of EORTC QLQ-CX24 was significantly different during follow-up (P= 0.02). Type of surgery, histopathological diagnosis, and the menopausal and marital status of the patients affected baseline body image scores (P= 0.032, 0.004, and 0.019 and 0.005, respectively). Patients who underwent chemotherapy had higher baseline body image scores when compared with patients without any chemotherapy before RT (P= 0.028). All the complaints of patients except body image scores improved during the follow-up period. The baseline and follow-up anxiety and depression scores did not differ significantly.ConclusionsAlthough pelvic RT deteriorated HRQoL in gynecologic cancer, patients’ improvement in HRQoL during follow-up was observed. Patients receiving RT could be reassured about the improvement of acute adverse effects in the course of treatment.

scholarly journals To study the short-term outcome of multimodality treatment on morbidity and quality of life in patients with carcinoma oesophagus

2017 ◽  
Vol 5 (4) ◽  
pp. 1594
Author(s):  
Karamveer Singh ◽  
Navneet Jain ◽  
Sunil Saini
Keyword(s):  
Quality Of Life ◽  
Multimodality Treatment ◽  
Symptom Improvement ◽  
Life Questionnaire ◽  
Curative Intent ◽  
European Organization ◽  
Female Ratio ◽  
Carcinoma Oesophagus

Background: Oesophageal cancer is sixth most common cause of cancer related deaths worldwide. Despite complete resections, overall survival remained low. To improve the existing treatment combination of chemotherapy and radiotherapy in both neoadjuvant and adjuvant settings was introduced. Impact of treatment on quality of life, morbidities and toxicities associated with multimodality treatment in patients of carcinoma oesophagus was studied prospectively and retrospectively.Methods: A total of 40 patients histologically proven carcinoma of the oesophagus were enrolled in the study. Study included assessment of clinical features, risk factors, biopsy, multimodality treatment and associated morbidities and toxicities. Quality of Life (QOL) in patients of multimodality treatment assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Core 18 before, immediate post treatment and 6 months after completion of the planned treatment.Results: In 40 patients, male to female ratio was 1.10:1. Dysphagia was the leading complain. 3 patients were treated using neoadjuvant therapy (chemotherapy and radiotherapy followed by surgery) among them 2 patients expired, 1 patient is under regular follow up. 6 patients underwent upfront surgery followed by adjuvant therapy out of which 3 patients expired,15 patients were treated with curative intent by definitive chemotherapy and radiotherapy out of which only 7 patients survived for >1 year. 16 patients were treated with palliative intent (radiotherapy, chemotherapy, oesophageal stenting and feeding procedures) in which only 1 patient survived for 1 year.Conclusions: The present study demonstrates that patients over all QOL was reduced after treatment and in the follow up period which was due to the treatment related toxicities but in contrast symptom improvement was observed simultaneously.

Quality of Life in Patients With Gastroenteropancreatic Tumors Treated With [177Lu-DOTA0,Tyr3]octreotate

2004 ◽  
Vol 22 (13) ◽  
pp. 2724-2729 ◽  
Author(s):  
Jaap J.M. Teunissen ◽  
Dik J. Kwekkeboom ◽  
Eric P. Krenning
Keyword(s):  
Quality Of Life ◽  
Global Health ◽  
Progressive Disease ◽  
Tumor Regression ◽  
Somatostatin Receptor ◽  
Disease Status ◽  
Life Questionnaire ◽  
European Organization

Purpose To evaluate the quality of life (QoL) in patients with metastatic somatostatin receptor positive gastroenteropancreatic tumors treated with [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate) therapy. Patients and Methods Fifty patients who had been treated with 600 to 800 mCi of 177Lu-octreotate and had a follow-up of at least 3 months were studied. The patients completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 before therapy and at follow-up visit 6 weeks after the last cycle. Overall QoL and specific QoL domains of both the total group of patients and subgroups according to treatment outcome were analyzed. Twenty-four patients had regression, 19 had stable disease, six had progressive disease, and one had nonassessable disease status. Analysis of variance was used for statistical comparison. Results A significant improvement in the global health status/QoL scale was observed after therapy with 177Lu-octreotate (P < .01). The score increased significantly six weeks after therapy to a mean of 78.2, up from 69.0 (scale range, 0 to 100). Furthermore, significant improvement was observed in the role, emotional, and social function scales. The symptom scores for fatigue, insomnia, and pain were significantly decreased. Patients with proven tumor regression most frequently had an improvement of QoL domains. Unexpectedly, patients with progressive disease also indicated an improvement in their global health/QoL score. Conclusion 177Lu-octreotate therapy significantly improved the global health/QoL and several function and symptom scales in patients with metastasized gastroenteropancreatic tumors, but especially in those patients with proven tumor regression.

Determining the Relationship Between Toxicity and Quality of Life in an Ovarian Cancer Chemotherapy Clinical Trial

2004 ◽  
Vol 22 (12) ◽  
pp. 2461-2468 ◽  
Author(s):  
Lorna Butler ◽  
Monica Bacon ◽  
Mark Carey ◽  
Benny Zee ◽  
Dongsheng Tu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Randomized Trial ◽  
European Organization ◽  
Change Scores ◽  
Prospective Longitudinal ◽  
Longitudinal Treatment ◽  
The Relationship

Purpose This analysis of data from a randomized trial of chemotherapy in epithelial ovarian cancer sought to determine whether a relationship exists between the presence and severity of the most commonly observed toxic effects and the corresponding quality of life (QOL) items. Patients and Methods One hundred fifty-two eligible patients accrued from Canada by the National Cancer Institute of Canada Clinical Trials Group on a randomized trial of paclitaxel and cisplatin versus cyclophosphamide/cisplatin were included in the analysis. Toxicity to the chemotherapeutic treatments was subjectively evaluated using a trial-specific checklist for ovarian cancer and the European Organization for Research and Treatment of Cancer QLQ C30+3 questionnaire. Assessments were conducted at baseline, before each cycle of treatment (3 weeks), and at each 3-month follow-up during the next 2 years (or until progression). Results The most frequently observed symptoms experienced during or shortly following chemotherapy were neurosensory loss, lethargy, nausea, vomiting, and alopecia. Regression analyses revealed that change scores of QOL items related to motor weakness and gastrointestinal pain were common predictors for the change global QOL score during protocol treatment; and change scores of QOL items related to lethargy or fatigue and change toxicity grade of mood predicted the change global QOL score after patients were off treatment. Conclusion The use of the European Organization for Research and Treatment of Cancer QLQ C30+3 and trial-specific checklist was able to assess the effect of expected toxicities on patient's QOL during and following treatment, and so may be useful in addressing the concerns regarding methodological issues that have limited the acquisition of prospective, longitudinal treatment-related toxicity data.

Feasibility of Early Application of an Advance Directive at the Time of First-Line Palliative Chemotherapy in Patients With Incurable Cancer: A Prospective Study

2019 ◽  
Vol 36 (10) ◽  
pp. 893-899
Author(s):  
Eun-Ju ParK ◽  
Yeon Jae Lim ◽  
Jae-Joon Kim ◽  
Sang-Bo Oh ◽  
So Yeon Oh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advance Directive ◽  
Palliative Chemotherapy ◽  
Life Questionnaire ◽  
First Line ◽  
European Organization ◽  
Before And After ◽  
Eortc Qlq

Context:This study aimed to evaluate the feasibility of an advance directive (AD) at the time of starting first-line palliative chemotherapy. We investigated changes in emotional distress, quality of life (QoL), and attitudes toward anticancer treatments between before and after AD.Methods:Patients with advanced cancer who had just started palliative chemotherapy were prospectively enrolled. We assessed attitudes toward chemotherapy, Hospital Anxiety and Depression Scale (HADS), and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ) before conducting the AD and subsequently performed the AD after the first cycle of chemotherapy. Follow-up evaluations using same parameters were performed in the next cycle visit.Results:During the study period, 104 patients started palliative chemotherapy. Among them, 41 patients (11 with cognitive impairment at baseline, 14 with clinical deteriorations after the first cycle of chemotherapy, 6 with follow-up loss, 7 without proxy, 3 with protocol violations) were excluded, and the AD were recommended in the remaining 64 patients (proportion of AD recommendation: 62%). Among the 64 patients, 44 agreed to conduct the AD (proportion of AD consent: 69%). There were no significant changes before and after AD in terms of HADS and EORTC-QLQ. Attitudes regarding chemotherapy were also unchanged ( P = .773). A total of 36 (82%) patients followed physician’s recommendations, with the exception of 8 patients who terminated chemotherapy due to refusal or loss to follow-up.Conclusions:Considering our results showing no significant changes in depression and anxiety scores, QoL, and attitudes toward anticancer treatments after the AD, early integration of the AD at initiation of first-line palliative chemotherapy might be feasible.

scholarly journals Quality of Life and Sexual Functioning After Vulvar Reconstruction With the Lotus Petal Flap

2018 ◽  
Vol 28 (9) ◽  
pp. 1728-1736 ◽  
Author(s):  
Joke Hellinga ◽  
Nienke C. te Grootenhuis ◽  
Paul M.N. Werker ◽  
Geertruida H. de Bock ◽  
Ate G.J. van der Zee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sexual Functioning ◽  
Life Questionnaire ◽  
European Organization ◽  
Healthy Women ◽  
Vulvar Reconstruction ◽  
Flap Procedure ◽  
Lotus Petal Flap

ObjectiveResection of (pre) malignant lesions in the vulvoperineal area may result in large defects that cannot be closed primarily. The lotus petal flap technique is widely used for reconstruction. The aim of this study was to evaluate both quality of life (QoL) and sexual functioning of patients who underwent the lotus petal flap procedure, because no data are available on this topic.MethodsA cross-sectional study was performed on all eligible patients (N = 38) who underwent the lotus petal flap procedure between 2005 and 2016. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, Female Sexual Function Index, and Body Image Scale were used to evaluate QoL and sexual functioning. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Female Sexual Function Index scores were compared with scores of age-matched healthy women.ResultsTwenty-six patients (68%) responded. The mean (SD) age was 65.5 (16.3) years, and the median follow-up time was 38.5 months (range 16–141 months). Quality of life scores were lower compared with healthy women in the domains physical, role, and social functioning. Sexual activity rates were comparable with healthy women; however, sexual functioning was worse. Although patients were satisfied about their sexual life, pain was reported.ConclusionsPatients who underwent vulvar reconstructive surgery with lotus petal flaps seem to have a lower QoL compared with healthy women. Patients report more pain during sexual activity but are satisfied about their sexual functioning. These results should be included in preoperative counseling and follow-up of future patients eligible for vulvar reconstruction with a lotus petal flap.

Symptoms and their implications on quality of life and psychological distress in sarcoma patients

2021 ◽  
Vol 17 (7) ◽  
pp. 817-823
Author(s):  
Gabriella Maggi ◽  
Irene Terrenato ◽  
Luca Giacomelli ◽  
Viviana Bifano ◽  
Alessandra Gravili ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Distress ◽  
Life Questionnaire ◽  
European Organization ◽  
Quality Of Life Questionnaire ◽  
Financial Difficulties ◽  
Few Data ◽  
Over Time

The aim of this study was to investigate symptoms, their variation over time and their relationship with quality of life (QoL)/psychological distress in sarcoma patients, as few data regarding QoL and psychological distress in this set of patients are currently available. A total of 188 sarcoma patients from an Italian referral center were involved. Symptoms and financial difficulties were evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire from the first treatment and over the follow-up period, up to 6 years. The authors found that patients with sarcoma experience several symptoms, especially fatigue and pain, which may dramatically worsen QoL and psychological distress. In conclusion, patients with sarcoma often experience fatigue, pain and financial difficulties, which negatively impacts QoL and psychological distress. To ameliorate overall QoL, proper control of symptoms is necessary.

scholarly journals Assessment of quality of life in resectable gastric cancer patients undergoing chemoradiotherapy as adjuvant treatmentLetter to the Editor

2018 ◽  
Vol 07 (01) ◽  
pp. 16-20 ◽  
Author(s):  
Deep Shankar Pruthi ◽  
Mushtaq Ahmad ◽  
Meenu Gupta ◽  
Saurabh Bansal ◽  
Vipul Nautiyal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adjuvant Treatment ◽  
Three Dimensional ◽  
Conformal Radiotherapy ◽  
Curative Intent ◽  
European Organization ◽  
Few Data ◽  
Gastric Cancer Patients

Abstract Introduction: Quality of life (QOL) is increasingly recognized as an important endpoint in cancer therapies. However, few data are available on QOL in patients who have received radiotherapy as adjuvant treatment for cancer stomach. Methods: Thirty patients who underwent curative resection were enrolled and received chemoradiotherapy (45 Gy in 25 fractions using three-dimensional conformal radiotherapy technique), together with 5-fluorouracil and leucovorin. The European Organization for Research and Treatment of Cancer QOL questionnaire C30 and STO Q22 was assessed at four time points: pre- and postchemoradiotherapy and at 1-month and 6-month follow-up. Results: Mean age of the patients was 54 years. Male:female ratio was 4:1. Stage II and Stage III disease was present in 60% and 30% of patients, respectively. All patients were able to complete the chemoradiotherapy protocol. Our study found out significant impairment in QOL for emotional functioning, fatigue, nausea and vomiting and dyspnea. Results showed that QOL levels decrease postchemoradiotherapy; however, QOL levels returned to baseline at 1-month and 6-month follow-up period. Conclusion: Chemoradiotherapy as adjuvant treatment for cancer stomach patients who have undergone resection with curative intent is a safe and well-tolerated regimen with respect to QOL.

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