title: The effect of lifestyle interventions on the quality of life of gynaecological cancer survivors: A systematic review and meta-analysis.
abstract: OBJECTIVE
  We aimed to evaluate the effectiveness of lifestyle interventions in improving the quality of life (QoL) of endometrial and ovarian cancer survivors.
  
  
  METHODS
  The review was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, and the Cochrane Handbook for Systematic Reviews of Interventions. We performed a search of MEDLINE (1946-2015), EMBASE (1980-2015), CINAHL (1981-2015), PsycINFO (1806-2015) and the Cochrane Trial Register to identify studies evaluating the effect of lifestyle interventions on the QoL of endometrial and ovarian cancer survivors.
  
  
  RESULTS
  Eight studies fulfilled the inclusion criteria and comprised a total of 413 patients. Three studies were randomised controlled trials (RCTs), which showed that lifestyle interventions may improve physical functioning and significantly reduce fatigue in endometrial cancer survivors. In addition, lifestyle interventions in endometrial cancer survivors resulted in significant weight loss and improved physical activity levels, but did not show improvements in global QoL in the meta-analysis (P=0.75, P=0.49). Non-randomised trials in ovarian cancer survivors support the feasibility of lifestyle interventions and suggest they may result in QoL improvements.
  
  
  CONCLUSIONS
  Lifestyle interventions have the potential to improve the QoL of endometrial cancer and ovarian cancer survivors, and may significantly reduce fatigue. However, the current evidence is limited and there is a need for future studies to further evaluate lifestyle interventions and their effect on QoL outcomes.
authors.affiliation: Gynaecological Oncology, Royal Cornwall Hospital Trust, Truro, United Kingdom.
authors.forename: Anke
authors.initials: A
authors.lastname: Smits
authors.affiliation: Gynaecological Oncology, Royal Cornwall Hospital Trust, Truro, United Kingdom.
authors.forename: Alberto
authors.initials: A
authors.lastname: Lopes
authors.affiliation: Gynaecological Oncology, Royal Cornwall Hospital Trust, Truro, United Kingdom.
authors.forename: Nagindra
authors.initials: N
authors.lastname: Das
authors.affiliation: Obstetrics & Gynaecology, Radboud UMC, Nijmegen, The Netherlands.
authors.forename: Ruud
authors.initials: R
authors.lastname: Bekkers
authors.affiliation: Obstetrics & Gynaecology, Radboud UMC, Nijmegen, The Netherlands.
authors.forename: Leon
authors.initials: L
authors.lastname: Massuger
authors.affiliation: Gynaecological Oncology, Royal Cornwall Hospital Trust, Truro, United Kingdom. Electronic address: khadra.galaal@rcht.cornwall.nhs.uk.
authors.forename: Khadra
authors.initials: K
authors.lastname: Galaal
mesh_terms: D004032:Diet; D016889:Endometrial Neoplasms / Q000534:rehabilitation*; D015444:Exercise; D005221:Fatigue / Q000628:therapy; D005260:Female; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D010051:Ovarian Neoplasms / Q000534:rehabilitation*; D011788:Quality of Life; D017741:Survivors; D015431:Weight Loss
keywords: Endometrial cancer; Exercise; Lifestyle intervention; Ovarian cancer; Quality of life; Survivorship