Reproductive and sexual function after platinum-based chemotherapy in long-term ovarian germ cell tumor survivors: a Gynecologic Oncology Group Study.
OBJECTIVE
To compare malignant ovarian germ cell tumor survivors with a matched control group of females on menstrual and reproductive outcomes, sexual functioning, and dyadic adjustment.


METHODS
Eligible patients met the following criteria: (1) history of malignant ovarian germ cell tumor; (2) treatment with surgery plus platinum-based chemotherapy; (3) age at least 18 years and continuously disease-free with minimum follow-up of 2 years; (4) capability of completing questionnaire and telephone interview; and (5) completion of written informed consent. The control group was drawn from acquaintances recommended by survivors and matched for age, race, and education. Scales with established reliability and validity were used to measure quality-of-life concepts of sexual functioning and social networks.


RESULTS
One hundred thirty-two survivors and 137 controls completed the study. Of 132 survivors, 71 (53.8%) had fertility-sparing surgery. Of fertile survivors, 62 (87.3%) reported still having menstrual periods. Twenty-four survivors reported 37 offspring after cancer treatment. Compared with controls, survivors had significantly greater reproductive concerns (P < .0001), less sexual pleasure (P = .003), and lower scores on the total Sexual Activity Scale Score (P = .001). However, survivors had better dyadic consensus (P = .004), dyadic satisfaction (P = .005), and dyadic cohesion (P = .014).


CONCLUSIONS
Women who had fertility-sparing surgery were very likely to retain menstrual function and fertility after chemotherapy. Although there is some increase in gynecologic symptoms and diminution in sexual pleasure, survivors tended to have stronger, more positive relationships with significant others.
Gershenson
David M
DM
Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77230-1439, USA. dgershen@mdanderson.org
Miller
Anna M
AM
Champion
Victoria L
VL
Monahan
Patrick O
PO
Zhao
Qianqian
Q
Cella
David
D
Williams
Stephen D
SD
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016022:Case-Control Studies; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000209:etiology* / Q000523:psychology; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D010051:Ovarian Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D043762:Reproductive Behavior; D012735:Sexual Dysfunction, Physiological / Q000150:complications / Q000209:etiology* / Q000523:psychology; D013997:Time Factors
D000970:Antineoplastic Agents; D002945:Cisplatin