Department of Gynecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark.
Int J Gynecol Cancer. 2013 Feb;23(2):227-34. doi: 10.1097/IGC.0b013e31827f37b0.
This article reviews the literature on quality of life (QoL) of gynecologic cancer survivors, their needs and preferences regarding follow-up, and possible predictors of long-term QoL.
A systematic literature search was made in the following databases: MEDLINE (PubMed), Bibliotek.dk, CINAHL, Cochrane, EMBASE, PsycINFO, and SveMed+. We searched the period 1995-2012 for English-language literature. The search was made during July 2011 to February 2012. When possible, the search was made using MeSH terms. Additional reports were collected by systematically viewing the reference lists of the retrieved articles.
Overall studies indicate that survivors after gynecologic cancer do not have impaired QoL in the long term. In general, the patients are highly satisfied with the follow-up program. The patients' greatest concern is fear of recurrence. The most frequent reported unmet need is help in dealing and living with the fear of recurrence. It seems that psychosocial status at time of diagnosis is determining for QoL and well-being in the long term. Association has been found between coping style and QoL, risk of depression, and anxiety in the long term after cancer.
Even though long-term QoL does not seem to be impaired, the patients are struggling with fear of recurrence, and the way of coping with this fear is a possible predictor for long-term QoL after cancer. However, there is a lack of evidence on QoL, needs, and preferences regarding follow-up of the survivors after gynecologic cancer. The quality of the follow-up regimen is questionable, and it is not evidence based. Thus, it is extremely important to optimize the follow-up program and move focus to life quality. There is a need for an evidence-based strategy regarding follow-up for low-risk gynecologic cancer patients.
本文回顾了妇科癌症生存者生活质量（QoL）、他们对随访的需求和偏好，以及长期 QoL 的可能预测因素的文献。
我们在以下数据库中进行了系统的文献检索：MEDLINE（PubMed）、Bibliotek.dk、CINAHL、Cochrane、EMBASE、PsycINFO 和 SveMed+。我们搜索了 1995 年至 2012 年期间的英文文献。搜索于 2011 年 7 月至 2012 年 2 月进行。在可能的情况下，使用 MeSH 术语进行搜索。通过系统地查看检索到的文章的参考文献列表，收集了额外的报告。
总体研究表明，妇科癌症后生存者的长期生活质量没有受损。一般来说，患者对随访方案非常满意。患者最关心的是对复发的恐惧。最常报告的未满足需求是帮助应对和处理复发恐惧。似乎诊断时的心理社会状态决定了长期的 QoL 和幸福感。已经发现应对方式与 QoL、癌症后长期抑郁和焦虑的风险之间存在关联。
尽管长期 QoL 似乎没有受损，但患者仍在与复发恐惧作斗争，应对这种恐惧的方式可能是癌症后长期 QoL 的一个预测因素。然而，缺乏关于妇科癌症生存者 QoL、需求和随访偏好的证据。随访方案的质量值得怀疑，并且没有证据支持。因此，优化随访计划并将重点转移到生活质量上至关重要。需要制定一种基于证据的低危妇科癌症患者随访策略。
