title: Quality of life and psychological distress in locally advanced cervical cancer patients administered pre-operative chemoradiotherapy.
abstract: OBJECTIVE
  The aim of the study was to analyze the Quality of life (QoL) scores in a single institution series of locally advanced cervical cancer patients (LACC) administered preoperative chemoradiation, compared to early stage disease (ECC) patients undergoing radical surgery.
  
  
  METHODS
  The following criteria were required in order to enroll patients: age between 18 and 65years at initial diagnosis, at least 12 months from the end of treatment, no evidence of recurrence/second malignancy. The SF-36 questionnaire on general health, and the HADS questionnaire on mental distress were utilized.
  
  
  RESULTS
  93 subjects were available for the analysis. At time of analysis, median follow-up was 30 months (range 12-120). LACC patients showed QoL scores comparable to ECC patients with the exception of physical functioning (mean+/-SD=69.0+/-13.1 versus mean+/- SD=85.4+/-16.2, p value=0.0007). In the group of LACC patients, the presence of co-morbidities was significantly associated with the impairment of almost all subscales of QoL. A low education level and the status of unemployment were documented to negatively impact on the vast majority of SF-36 subscale scores. In the multivariate analysis, the presence of co-morbidities, low educational level, age> 50 years, and unemployment maintained their independent negative association with poor QoL scores. The percentage of cases with high levels HADS-anxiety was higher in LACC than ECC patients (27.6% versus 8.6%, p value=0.034).
  
  
  CONCLUSIONS
  LACC patients administered preoperative chemoradiation showed QoL scores comparable to EEC patients, and a higher proportion of anxiety disorders; low educational level and unemployment status were mainly associated with poor QoL scores.
authors.affiliation: Department Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University, Rome, Italy.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Distefano
authors.forename: Silvia
authors.initials: S
authors.lastname: Riccardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Capelli
authors.forename: Barbara
authors.initials: B
authors.lastname: Costantini
authors.forename: Marco
authors.initials: M
authors.lastname: Petrillo
authors.forename: Caterina
authors.initials: C
authors.lastname: Ricci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ferrandina
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003131:Combined Modality Therapy; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D011788:Quality of Life; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery / Q000628:therapy*