title: Quality of life after radical trachelectomy for early-stage cervical cancer: A 5-year prospective evaluation.
abstract: OBJECTIVE
  To longitudinally assess quality of life (QOL) in women undergoing radical trachelectomy for early-stage cervical cancer.
  
  
  METHODS
  We prospectively enrolled patients with stage IA1-IB1 cervical cancer prior to undergoing radical trachelectomy to complete validated QOL instruments. These instruments included the General Health-Related QOL (SF-12), Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision scale (SWD). Instruments were filled out at baseline, postoperatively at 6weeks, 6months, 1year, and annually thereafter for 4years.
  
  
  RESULTS
  Thirty-nine patients enrolled in the study, and 32 patients were evaluable. The scores for FSFI-arousal (p=0.0002), lubrication (p<0.0001), orgasm (p=0.006), pain (p=0.01), satisfaction (p=0.03) and total score (p=0.004) showed a significant decline at 6weeks then returned to baseline levels by 6 months. The scores for FACT-Cx functional well-being (p=0.02) and physical well-being (p<0.0001), SF-12 bodily pain (p<0.0001), physical functioning (p<0.0001), role physical (p<0.0001), role emotional (p=0.03), social functioning (p=0.002), and MDASI total (p=0.04) showed significantly worsened symptoms at 6weeks then returned to baseline by 6months. The scores for FACT-Cx emotional well-being showed significant worsening of symptoms that persisted at 6-weeks (p=0.004), 6months (p=0.007), 1year (p=0.001), 2years (p=0.002), and 4 years (p=0.03). There was no difference in SWD.
  
  
  CONCLUSIONS
  Several quality of life assessments decline immediately postoperatively after radical trachelectomy, however, return to baseline thereafter. The long-term emotional impact of this surgery highlights a need for perioperative counseling in these patients.
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States. Electronic address: nfleming@mdanderson.org.
authors.forename: N D
authors.initials: ND
authors.lastname: Fleming
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: P T
authors.initials: PT
authors.lastname: Ramirez
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: P T
authors.initials: PT
authors.lastname: Soliman
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: K M
authors.initials: KM
authors.lastname: Schmeler
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: G B
authors.initials: GB
authors.lastname: Chisholm
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: A M
authors.initials: AM
authors.lastname: Nick
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: S N
authors.initials: SN
authors.lastname: Westin
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
authors.forename: M
authors.initials: M
authors.lastname: Frumovitz
mesh_terms: D000203:Activities of Daily Living; D000230:Adenocarcinoma / Q000473:pathology / Q000523:psychology / Q000601:surgery; D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000523:psychology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000453:epidemiology*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012380:Role; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology* / Q000523:psychology; D058992:Social Participation; D000069339:Trachelectomy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D055815:Young Adult
keywords: Cervical cancer; Quality of life; Trachelectomy