Novackova Marta, Halaska Michael J, Robova Helena, Mala Ivana, Pluta Marek, Chmel Roman, Rob Lukas
*Department of Obstetrics and Gynecology, 2nd Faculty of Medicine of the Charles University in Prague and Faculty Hospital Motol; and †Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic.
Int J Gynecol Cancer. 2015 Jan;25(1):166-73. doi: 10.1097/IGC.0000000000000313.
The aim of this study was to prospectively monitor the patients' quality of life (QoL) after vulvar cancer surgery.
The design was prospective clinical study.
The study was set in the Department of Obstetrics and Gynecology, 2nd Medical Faculty of the Charles University and University Hospital Motol, Prague, Czech Republic.
A group of 36 patients underwent vulvar cancer surgery: 24 patients were subject to inguinofemoral lymphadenectomy (RAD) and 12 to sentinel lymph node biopsy. To evaluate QoL, the European Organisation for Research and Treatment of Cancer, QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 and 12 months after surgery.
In patients with vulvar cancer after inguinofemoral lymphadenectomy, increased fatigue and impaired lymphedema were observed. In the group of patients after sentinel lymph node biopsy, none of the QoL variables worsened postoperatively. Comparing both groups 12 months after surgery, the RAD group had significantly worse outcomes in body image and cognitive functioning than the sentinel lymph node biopsy group.Patients in the RAD group, who received adjuvant radiotherapy (n = 13), had worse QoL in symptom experience (P < 0.05) at 6 and 12 months after the surgery than patients without radiotherapy (n = 11).
Less radical surgery showed objectively better QoL results.
本研究的目的是前瞻性监测外阴癌手术后患者的生活质量（QoL）。
设计为前瞻性临床研究。
该研究在捷克共和国布拉格查理大学第二医学院妇产科和Motol大学医院进行。
一组36例患者接受了外阴癌手术：24例患者接受腹股沟股淋巴结清扫术（RAD），12例接受前哨淋巴结活检。为了评估生活质量，在手术前以及手术后6个月和12个月向患者发放了欧洲癌症研究与治疗组织的生活质量问卷（QLQ-C30和QLQ-CX24）。
在接受腹股沟股淋巴结清扫术的外阴癌患者中，观察到疲劳加剧和淋巴水肿受损。在前哨淋巴结活检后的患者组中，术后没有生活质量变量恶化。在手术后12个月比较两组时，RAD组在身体形象和认知功能方面的结果明显比前哨淋巴结活检组差。接受辅助放疗的RAD组患者（n = 13）在手术后6个月和12个月的症状体验方面的生活质量比未接受放疗的患者（n = 11）差（P < 0.05）。
手术范围较小的手术在客观上显示出更好的生活质量结果。
