A 2-year prospective study assessing the emotional, sexual, and quality of life concerns of women undergoing radical trachelectomy versus radical hysterectomy for treatment of early-stage cervical cancer.
OBJECTIVE
To prospectively assess and describe the emotional, sexual, and QOL concerns of women with early-stage cervical cancer undergoing radical surgery.


METHODS
Seventy-one women who were consented for radical trachelectomy (RT) or radical hysterectomy (RH) were enrolled preoperatively in this 2-year study; 52 women (33 RT; 19 RH) were actively followed. Patients completed self-report surveys composed of 4 empirical measures in addition to exploratory items. Data analyses for the 2 years of prospective data are presented.


RESULTS
At preoperative assessment, women choosing RH reported greater concern about cancer recurrence (x=7.27 [scale from 0 to 10]) than women choosing RT (x=5.66) (P=0.008). Forty-eight percent undergoing RH compared to 8.6% undergoing RT reported having adequate "time to complete childbearing" (P<0.001). Both groups demonstrated scores suggestive of depression (based on the CES-D scale) and distress (based on the IES scale) preoperatively; over time, however, CES-D and IES scores generally improved. Scores on the Female Sexual Functioning Inventory (FSFI) for the total sample were below the mean cut-off (26.55), suggestive of sexual dysfunction; however, the means increased from 16.79 preoperatively to 23.78 by 12 months and 22.20 at 24 months.


CONCLUSIONS
Measurements of mood, distress, sexual function, and QOL did not differ significantly by surgical type, and instead reflect the challenges faced by young cervical cancer patients treated by RT or RH without adjuvant treatment. Points of vulnerability were identified in which patients may benefit from preoperative consultation or immediate postoperative support. Overall, patients improved during the first year, reaching a plateau between Year-1 and Year-2, which may reflect a new level of functioning in survivorship.
Carter
Jeanne
J
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. gynbreast@mskcc.org
Sonoda
Yukio
Y
Baser
Raymond E
RE
Raviv
Leigh
L
Chi
Dennis S
DS
Barakat
Richard R
RR
Iasonos
Alexia
A
Brown
Carol L
CL
Abu-Rustum
Nadeem R
NR
D000328:Adult; D004644:Emotions; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D010052:Ovariectomy; D011446:Prospective Studies; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D019529:Sexuality; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D055815:Young Adult
Clin Cancer Res. 2008 Apr 1;14(7):2111-8
18381952
Gynecol Oncol. 2008 Nov;111(2):255-60
18755500
Gynecol Oncol. 2007 Apr;105(1):13-6
17188344
Gynecol Oncol. 2008 Oct;111(1):151-7
18662827
Gynecol Obstet Fertil. 2003 Sep;31(9):706-12
14499714
Gynecol Oncol. 2008 Dec;111(3):555-60
18829092
J Clin Oncol. 1993 Mar;11(3):570-9
8445433
Gynecol Oncol. 2008 Nov;111(2 Suppl):S105-10
18755501
J Natl Cancer Inst Monogr. 2005;(34):94-8
15784834
J Clin Oncol. 2005 Jul 20;23(21):4617-25
15911864
Gynecol Oncol. 2004 Dec;95(3):534-8
15581959
BJOG. 2006 Jun;113(6):719-24
16709216
Curr Opin Oncol. 2008 Sep;20(5):575-80
19106664
Psychosom Med. 1979 May;41(3):209-18
472086
Am J Obstet Gynecol. 2003 Nov;189(5):1378-82
14634572
J Sex Marital Ther. 2000 Apr-Jun;26(2):191-208
10782451
J Clin Oncol. 2006 Apr 1;24(10):1620-6
16575013
Gynecol Oncol. 2009 Jan;112(1):73-7
18973933
J Cancer Surviv. 2010 Sep;4(3):236-46
20373042