title: Controlled study of fatigue, quality of life, and somatic and mental morbidity in epithelial ovarian cancer survivors: how lucky are the lucky ones?
abstract: OBJECTIVE
  There are few studies of somatic and mental morbidity in epithelial ovarian cancer survivors (EOCSs). The aim of this controlled, cross-sectional study was to explore fatigue, quality of life (QOL), and somatic and mental morbidity in EOCSs.
  
  
  METHODS
  Among 287 EOCSs treated according to protocols at The Norwegian Radium Hospital between 1977 and 2003, 189 patients (66%) participated. Information was collected by a questionnaire containing demographic and morbidity items and self-rating scales. Internal comparisons of various subgroups of EOCSs were performed, and EOCSs were compared with age-adjusted controls from the general population.
  
  
  RESULTS
  Minimal differences were observed relating to somatic and mental morbidity, fatigue, and QOL between EOCSs with and without relapse, long or short follow-up time, and prognostic index status. Chronic fatigue was found in 22% (95% CI, 16% to 28%), and only body image was significantly associated with chronic fatigue in multivariable analyses. EOCSs showed significantly more somatic and mental morbidity, somatic complaints, use of medications, and use of health care services than controls. The levels of anxiety and fatigue were also significantly higher in EOCSs than in controls, whereas the levels of depression and of several QOL dimensions were lower. The prevalence of chronic fatigue was 12% among controls.
  
  
  CONCLUSIONS
  EOCSs had more somatic and mental morbidity, more fatigue, poorer QOL, and used more medication and health services than controls. Minimal differences were observed between various EOCS subgroups. Health care professionals should try to improve and be attentive to the health of EOCSs.
authors.affiliation: Department of Gynecology, Sorlandet Hospital HF, Arendal, Norway. astrid.liavaag@sshf.no
authors.forename: Astrid H
authors.initials: AH
authors.lastname: Liavaag
authors.forename: Anne
authors.initials: A
authors.lastname: Dørum
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Claes
authors.initials: C
authors.lastname: Tropé
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009017:Morbidity; D009375:Neoplasms, Glandular and Epithelial / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D009664:Norway / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors