M Bossart1,2, H Plett3, B Krämer4, E Braicu5, B Czogalla6, M Klar7, S Singer8,9, D Mayr10, A Staebler11, A du Bois3, S Kommoss4, T Link12, A Burges6, F Heitz3, M Grube4, F Trillsch6, P Harter3, P Wimberger12, P Buderath13, A Hasenburg9. 1. Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg im Breisgau, Germany. Michaela.Bossart@rkk-klinikum.de. 2. Department of Gynecology and Obstetrics, St. Josefskrankenhaus Freiburg, Freiburg im Breisgau, Germany. Michaela.Bossart@rkk-klinikum.de. 3. Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte (KEM), Essen, Germany. 4. Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany. 5. Department of Gynecology, Charité Berlin, Campus Virchow Clinic, Berlin, Germany. 6. Department of Obstetrics and Gynecology, University Hospital, Ludwig- Maximilians- University Munich, Munich, Germany. 7. Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg im Breisgau, Germany. 8. Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Epidemiology and Health Care Research, University Medical Center Mainz, Mainz, Germany. 9. Department of Gynecology and Obstetrics, University Medical Center Mainz, Mainz, Germany. 10. Institut of Pathology, Ludwig-Maximilians- University Munich, Munich, Germany. 11. Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University of Tuebingen, Tuebingen, Germany. 12. Department of Gynecology and Obstetrics, Technische Universität Dresden Dresden and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany. 13. Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany.
Abstract
INTRODUCTION: The intention of this study was to evaluate the level of anxiety and depression of malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) survivors and to identify possible alterable cofactors. METHODS: CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO Studygroup. Women who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete the Hospital Anxiety and Depression Scale (HADS) to evaluate distress. Predictors of distress (type of surgery, chemotherapy, time since diagnosis, recurrence, second tumor, pain) were investigated using multivariate linear regression analysis. RESULTS: 150 MOGCT and SCST patients with confirmed histological diagnosis completed the questionnaire median seven years after diagnosis. They had a HADS total score ≥ 13 indicating severe mental distress in 34% of cases. Patients after fertility-conserving surgery had lower probability of severe mental distress than those without fertility-conserving treatment (β = - 3.1, p = 0.04). Pain was associated with the level of distress in uni- and multivariate analysis (coef 0.1, p < 0.01, coef. Beta 0.5). DISCUSSION: Severe mental distress was frequent in patients with MOGCT and SCST and the level of pain was associated with the level of distress. Fertility conserving therapy, however, was associated with less mental distress. Screening and treatment of pain and depression is required to improve mental well-being in survivors of MOGCT and SCST.
INTRODUCTION: The intention of this study was to evaluate the level of anxiety and depression of malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) survivors and to identify possible alterable cofactors. METHODS: CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO Studygroup. Women who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete the Hospital Anxiety and Depression Scale (HADS) to evaluate distress. Predictors of distress (type of surgery, chemotherapy, time since diagnosis, recurrence, second tumor, pain) were investigated using multivariate linear regression analysis. RESULTS: 150 MOGCT and SCST patients with confirmed histological diagnosis completed the questionnaire median seven years after diagnosis. They had a HADS total score ≥ 13 indicating severe mental distress in 34% of cases. Patients after fertility-conserving surgery had lower probability of severe mental distress than those without fertility-conserving treatment (β = - 3.1, p = 0.04). Pain was associated with the level of distress in uni- and multivariate analysis (coef 0.1, p < 0.01, coef. Beta 0.5). DISCUSSION: Severe mental distress was frequent in patients with MOGCT and SCST and the level of pain was associated with the level of distress. Fertility conserving therapy, however, was associated with less mental distress. Screening and treatment of pain and depression is required to improve mental well-being in survivors of MOGCT and SCST.
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