title: 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.
abstract: 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. gynbreast@mskcc.org
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carter
authors.forename: Yukio
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Baser
authors.forename: Leigh
authors.initials: L
authors.lastname: Raviv
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Chi
authors.forename: Richard R
authors.initials: RR
authors.lastname: Barakat
authors.forename: Alexia
authors.initials: A
authors.lastname: Iasonos
authors.forename: Carol L
authors.initials: CL
authors.lastname: Brown
authors.forename: Nadeem R
authors.initials: NR
authors.lastname: Abu-Rustum
mesh_terms: 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
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