title: Evaluation of quality of life and emotional distress in endometrial cancer patients: a 2-year prospective, longitudinal study.
abstract: OBJECTIVE
  The aim of the study was to prospectively, and longitudinally assess Quality of Life (QoL) and emotional distress in a large series of endometrial cancer (EC) patients.
  
  
  METHODS
  Global Health Status of the EORTC QLQ-C30 (GHS), the EORTC QLQ-CX24 (CX24), and the Hospital Anxiety and Depression Scale (HADS) questionnaires were administered at diagnosis, and after 3, 6, 12, and 24months since surgery. The Generalized Linear Model and the Between Subject test were used to analyze QoL changes over time, and the association between factors and patient QoL.
  
  
  RESULTS
  GHS scores improved over time, although the statistical significance was not reached. Worse lymphedema scores were documented worsened over time with a trend to recover at the 12- and 24month evaluation (p-value=0.028). Scores for Menopausal Symptoms (MS) dramatically worsened over time reaching a 38.5 difference of mean±SE compared to baseline (p-value=0.011). Sexual Activity (SxA) scores improved until the 12-month evaluation (p-value=0.048), and showed a return to baseline levels at the last assessment (p-value=0.025). A significant improvement of anxiety scores was documented at the 3-month evaluation, and persisted over time. In multivariate analysis, unmarried status was associated with poor scores for sexual activity, while living with someone was associated with worse MS scores.
  
  
  CONCLUSIONS
  Menopausal and lymphedema symptoms heavily affect QoL in EC patients. Since socio-demographic features play a major role in deteriorating SxA and MS, psycho-social intervention and patient education should be considered as an integral part of EC patient treatment.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Catholic University, Rome, Italy. Electronic address: gabriella.ferrandina@libero.it.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ferrandina
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Petrillo
authors.affiliation: Psycho-Oncology Service, Fondazione "Giovanni Paolo II", Campobasso, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mantegna
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
authors.forename: Gilda
authors.initials: G
authors.lastname: Fuoco
authors.affiliation: Psycho-Oncology Service, Fondazione "Giovanni Paolo II", Campobasso, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Terzano
authors.affiliation: Psycho-Oncology Service, Fondazione "Giovanni Paolo II", Campobasso, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Venditti
authors.affiliation: CEIS, Sanitá (CHEM-Centre for Health Economics and Management), University of Tor Vergata, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Marcellusi
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: De Vincenzo
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Catholic University, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D017024:Chemotherapy, Adjuvant; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D007044:Hysterectomy; D008137:Longitudinal Studies; D008197:Lymph Node Excision; D008209:Lymphedema / Q000453:epidemiology / Q000523:psychology; D017533:Marital Status / Q000706:statistics & numerical data; D008593:Menopause / Q000502:physiology / Q000523:psychology*; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*
keywords: Emotional distress; Endometrial cancer; Prospective study; Quality of Life