Comparison of surgery or radiotherapy on complications and quality of life in patients with the stage IB and IIA uterine cervical cancer.
OBJECTIVE
To compare the long-term complications and quality of life of patients with stage IB and stage IIA uterine cervical carcinoma treated by surgery or radiotherapy.


METHODS
From August 2003 to May 2004, 202 patients with uterine cervical carcinoma were treated with surgery or radiotherapy at two institutions and were enrolled in this study upon follow-up at least 2 years post treatment. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and complications Questionnaire.


RESULTS
Constipation (p<0.001), flushing (p<0.001), dysuria (p<0.001), urinary incontinence (p<0.01), dysparia (p<0.05) and vaginal dryness (p<0.05) were statistically higher in the surgery treated group, while diarrhea (p<0.001), bloody stools (p<0.001) and abdominal pain (p<0.01) were higher in the radiotherapy group. Using factor analysis and introducing personal conditioned variables, pelvic neural dysfunction was significantly higher in surgery group and intestinal dysfunction was higher in radiotherapy group. There was no difference in sexual dysfunction between these two modalities. Comparison of EORTC QLQ-C30 showed that the majority of issues had minimal differences between these two treatment modalities, except social functioning (p<0.05; higher in radiotherapy group), constipation (p<0.001; higher in surgery group) and diarrhea (p<0.01; higher in radiotherapy group).


CONCLUSIONS
In early stage uterine cervical cancer patients, surgery or radiotherapy resulted in different complications, whereas long-term quality of life showed few differences between these two different modalities. These data were helpful for physicians in regards to the changes of patients, and moreover, for rehabilitation and supportive care of the patients after treatment.
Hsu
Wei-Chung
WC
Department of Radiation Oncology, Cheng Ching General Hospital, Taichung, Taiwan.
Chung
Na-Na
NN
Department of Radiation Oncology, Cheng Ching General Hospital, Taichung, Taiwan.
Chen
Yu-Chia
YC
Program of Indigenous Social Work, College of Indigenous Studies, National Dong Hwa University, Hualien, Taiwan, No. 1, Sec. 2, Da Hsueh Rd., Shoufeng, Hualien 97401, Taiwan. Electronic address: yuchiachenn@yahoo.com.tw.
Ting
Lai-Lei
LL
Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Department of Radiology, Medical College, National Taiwan University, Taipei, Taiwan.
Wang
Po-Ming
PM
Department of Radiation Oncology, Cheng Ching General Hospital, Taichung, Taiwan.
Hsieh
Pao-Chun
PC
Department of Obstetrics and Gynecology, Cheng Ching General Hospital, Taichung, Taiwan.
Chan
Shu-Ching
SC
Department of Healthcare Administration, Asia University, Taichung, Taiwan.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*