title: Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches.
abstract: The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer.
  
  
  
  One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group.
  
  
  
  There was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, -0.03 to -0.001; PSQ-III P = 0.002; 95% confidence interval, -0.003 to -0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07).
  
  
  
  Individualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.
authors.affiliation: *Department of Women's Cancer, The UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London; †Centre for Biostatistics, The University of Manchester, Manchester; ‡University College London Hospitals (UCLH) Gynaecological Cancer Centre; §Department of Applied Health Research, University College London; ‖Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom; and ¶University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: Lanceley
authors.forename: Carlo
authors.initials: C
authors.lastname: Berzuini
authors.forename: Matthew
authors.initials: M
authors.lastname: Burnell
authors.forename: Sue
authors.initials: S
authors.lastname: Gessler
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
authors.forename: Andy
authors.initials: A
authors.lastname: Ryan
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Ledermann
authors.forename: Ian
authors.initials: I
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000451:nursing / Q000523:psychology*; D017060:Patient Satisfaction; D057285:Precision Medicine / Q000379:methods* / Q000451:nursing; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D055815:Young Adult