A prospective study of quality of life in patients undergoing pelvic exenteration: interim results.
OBJECTIVE
Little prospective data exist on quality of life (QOL) after pelvic exenteration (PE). This ongoing study prospectively examines the QOL changes following this radical procedure using a comprehensive battery of psychological instruments.


METHODS
Since 2005, enrolled patients were interviewed (EORTC QLQ-C30, EORTC QLQ-CR38, EORTC QLQ-BLM30, BFI, BPI-SF, IADL, CES-D, IES-R) preoperatively and at 3, 6, and 12 months after PE for physical/psychological symptoms. Data were examined using repeated measure ANOVA.


RESULTS
Sixteen women (3 anterior, 1 posterior, and 12 total PEs), with more than 1 year of follow-up, completed all scheduled interviews. Median age was 58 years (range, 28-76 years). Overall QOL (F = 6.3, p < 0.02), ability to perform instrumental daily activities (F = 6.8, p < 0.02), body image (F = 11.9, p < 0.00), and sexual function (F = 8.0, p < 0.01) all declined at 3 months but were near baseline by 12 months after PE. Although, overall, physical function followed a similar trend (F = 14.8, p < 0.00), it did not return to baseline. At the 12-month interview, patients reported increased gastrointestinal symptoms (F = 8.9, p < 0.01) but significantly less stress-related ideation (F = 6.1, p < 0.03) compared to baseline. Pain levels did not change significantly during the study period (F = 0.4, p < 0.74).


CONCLUSIONS
Although patients report lingering gastrointestinal symptoms and some persistent decline in physical function after PE, most adjust well, returning to almost baseline functioning within a year. Providers can counsel patients that many, though not all, symptoms in the first 3 months following exenteration are likely to improve as they adapt to their changed health status. These preliminary results await confirmation of a larger analysis.
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Michigan, Ann Arbor, MI, USA.
Youssef A
YA
Rezk
Karen E
KE
Hurley
Jeanne
J
Carter
Fanny
F
Dao
Bernard H
BH
Bochner
Janice J
JJ
Aubey
Aileen
A
Caceres
M Heather
MH
Einstein
Nadeem R
NR
Abu-Rustum
Richard R
RR
Barakat
Vicky
V
Makker
Dennis S
DS
Chi
D000328:Adult; D000368:Aged; D001828:Body Image; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010149:Postoperative Pain / Q000523:psychology; D010385:Pelvic Exenteration / Q000009:adverse effects / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life