Sarah E Ferguson1, Tony Panzarella2, Susie Lau3, Lilian T Gien4, Vanessa Samouëlian5, Christopher Giede6, Helen Steed7, Tien Le8, Ben Renkosinski9, Marcus Q Bernardini10. 1. Division of Gynecologic Oncology, Princess Margaret Cancer Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada. Electronic address: Sarah.Ferguson@uhn.ca. 2. Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Canada. 3. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Canada. 4. Division of Gynecologic Oncology, Odette Cancer Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada. 5. Division Department of Obstetrics and Gynecology, Université de Montréal, Division of Gynecologic Oncology, CHUM, Institut du Cancer de Montréal, CRCHUM, Montréal, Canada. 6. Division of Gynecologic Oncology, University of Saskatoon, Saskatoon, Canada. 7. Division of Gynecologic Oncology, University of Alberta, Edmonton, Canada. 8. Division of Gynecologic Oncology, University of Ottawa, Ottawa, Canada. 9. Division of Gynecologic Oncology, Princess Margaret Cancer Centre, Toronto, Canada. 10. Division of Gynecologic Oncology, Princess Margaret Cancer Centre, Toronto, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada.
Abstract
OBJECTIVE: To evaluate patient-reported outcomes (PROs) between women treated by laparoscopic, robotic and open approaches for endometrial cancer. METHODS: Prospective cohort study comparing PRO at baseline, short- (1 and 3 weeks) and long-term (12 and 24 weeks) follow-up postoperatively. Quality of life (QOL) measures were the Functional Assessment of Cancer Therapy (FACT-G), EuroQol Five Dimensions (EQ-5D), and Brief Pain Inventory (BPI). Sexual health measures were the Female Sexual Function Index (FSFI) and the Sexual Adjustment and Body Image Scale for Gynecologic Cancer (SABIS-G). RESULTS: 468 eligible patients (laparotomy = 92, laparoscopy = 152, robotic = 224) were recruited. There were no significant differences between the laparoscopy and robotic groups for any PRO (P > 0.05). At short-term follow-up, patients who underwent minimally invasive surgery (robotic or laparoscopy) had significantly higher FACT-G (P < 0.0001) and EQ-5D (P < 0.0001) scores, with less pain (P = 0.02) and improved pain interference (P = 0.0008), than patients undergoing laparotomy. At long-term follow-up, there were sustained improvements in the FACT-G (P = 0.035) and the health state EQ-5D visual analogue scale (P = 0.022). Surgical approach had no impact on sexual health (P > 0.05); however the mean FSFI score for the entire cohort met clinical cut-offs for sexual dysfunction. CONCLUSION: Minimally invasive approaches result in improved QOL beyond the short-term postoperative period, with benefits noted up to 12 weeks after surgery. This prolonged QOL advantage provides further evidence that MIS should be the standard surgical approach for women with early stage endometrial cancer.
OBJECTIVE: To evaluate patient-reported outcomes (PROs) between women treated by laparoscopic, robotic and open approaches for endometrial cancer. METHODS: Prospective cohort study comparing PRO at baseline, short- (1 and 3 weeks) and long-term (12 and 24 weeks) follow-up postoperatively. Quality of life (QOL) measures were the Functional Assessment of Cancer Therapy (FACT-G), EuroQol Five Dimensions (EQ-5D), and Brief Pain Inventory (BPI). Sexual health measures were the Female Sexual Function Index (FSFI) and the Sexual Adjustment and Body Image Scale for Gynecologic Cancer (SABIS-G). RESULTS: 468 eligible patients (laparotomy = 92, laparoscopy = 152, robotic = 224) were recruited. There were no significant differences between the laparoscopy and robotic groups for any PRO (P > 0.05). At short-term follow-up, patients who underwent minimally invasive surgery (robotic or laparoscopy) had significantly higher FACT-G (P < 0.0001) and EQ-5D (P < 0.0001) scores, with less pain (P = 0.02) and improved pain interference (P = 0.0008), than patients undergoing laparotomy. At long-term follow-up, there were sustained improvements in the FACT-G (P = 0.035) and the health state EQ-5D visual analogue scale (P = 0.022). Surgical approach had no impact on sexual health (P > 0.05); however the mean FSFI score for the entire cohort met clinical cut-offs for sexual dysfunction. CONCLUSION: Minimally invasive approaches result in improved QOL beyond the short-term postoperative period, with benefits noted up to 12 weeks after surgery. This prolonged QOL advantage provides further evidence that MIS should be the standard surgical approach for women with early stage endometrial cancer.
Authors: Homan Mohammadi; Austin Prince; Nicholas B Figura; Jeffrey S Peacock; Daniel C Fernandez; Michael E Montejo; Hye Sook Chon; Robert M Wenham; Steven A Eschrich; Javier F Torres-Roca; Kamran A Ahmed Journal: Int J Radiat Oncol Biol Phys Date: 2019-11-20 Impact factor: 7.038
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