A Martinez1,2, T Filleron3, P Rouanet4, P Méeus5, E Lambaudie6, J M Classe7, F Foucher8, F Narducci9, S Gouy10, F Guyon11, F Marchal12, E Jouve13, P E Colombo4, A Mourregot4, M Rivoire5, N Chopin4, G Houvenaeghel6, I Jaffre7, J Leveque8, V Lavoue8, E Leblanc9, P Morice10, E Stoeckle11, J L Verheaghe12, D Querleu11, G Ferron13. 1. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse, France. martinez.alejandra@iuct-oncopole.fr. 2. Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR 1037 INSERM, Toulouse, France. martinez.alejandra@iuct-oncopole.fr. 3. Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse, France. 4. Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France. 5. Department of Surgical Oncology, CLCC Léon Bérard, Lyon, France. 6. Department of Surgical Oncology, CLCC Paoli-Calmettes, Marseille, France. 7. Department of Surgical Oncology, CLCC Institut Cancérologique de l'ouest, Nantes, France. 8. Department of Surgical Oncology, CHU Rennes, Rennes, France. 9. Department of Surgical Oncology, CLCC Oscar Lambret, Lille, France. 10. Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France. 11. Department of Surgical Oncology, Institut Bergonié, Bordeaux, France. 12. Department of Surgical Oncology, Institut Cancérologie de Lorraine, Nancy, France. 13. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse, France.
Abstract
BACKGROUND: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. METHODS: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration. Quality of life by measurement of functional and symptom scales was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 questionnaires before surgery, at baseline, and 1, 3, 6, and 12 months after the procedure. RESULTS: The study enrolled 97 patients. Quality of life including physical, personal, fatigue, and anorexia reported in the QLQ-C30 was significantly reduced 1 month postoperatively and improved at least to baseline level 1 year after the procedure. Body image also was significantly reduced 1 month postoperatively. Global health, emotional, dyspnea, and anorexia items were significantly improved 1 year after surgery compared with baseline values. Unlike younger patients, elderly patients did not regain physical and social activities after pelvic exenteration. CONCLUSIONS: Therapeutic decision on performing a pelvic exenteration can have a severe and permanent impact on all aspects of patients' QOL. Deterioration of QOL was most significant during the first 3 months after surgery. Elderly patients were the only group of patients with permanent decreased physical and social function. Preoperative evaluation and postoperative follow-up evaluation should include health-related QOL instruments, counseling by a multidisciplinary team to cover all aspects concerning stoma care, sexual function, and long-term concerns after surgery.
BACKGROUND: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. METHODS: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration. Quality of life by measurement of functional and symptom scales was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 questionnaires before surgery, at baseline, and 1, 3, 6, and 12 months after the procedure. RESULTS: The study enrolled 97 patients. Quality of life including physical, personal, fatigue, and anorexia reported in the QLQ-C30 was significantly reduced 1 month postoperatively and improved at least to baseline level 1 year after the procedure. Body image also was significantly reduced 1 month postoperatively. Global health, emotional, dyspnea, and anorexia items were significantly improved 1 year after surgery compared with baseline values. Unlike younger patients, elderly patients did not regain physical and social activities after pelvic exenteration. CONCLUSIONS: Therapeutic decision on performing a pelvic exenteration can have a severe and permanent impact on all aspects of patients' QOL. Deterioration of QOL was most significant during the first 3 months after surgery. Elderly patients were the only group of patients with permanent decreased physical and social function. Preoperative evaluation and postoperative follow-up evaluation should include health-related QOL instruments, counseling by a multidisciplinary team to cover all aspects concerning stoma care, sexual function, and long-term concerns after surgery.
Authors: Sophie Bockel; Sophie Espenel; Roger Sun; Isabelle Dumas; Sébastien Gouy; Philippe Morice; Cyrus Chargari Journal: Cancers (Basel) Date: 2021-03-11 Impact factor: 6.639
Authors: Carlos Martínez-Gómez; Martina Aida Angeles; Alejandra Martinez; Bernard Malavaud; Gwenael Ferron Journal: Int J Gynecol Cancer Date: 2020-11-23 Impact factor: 3.437