Soo Hoo San, Marriott Natalie, Houlton Aimee, Nevin James, Balega Janos, Singh Kavita, Yap Jason, Sethuram Ramya, Elattar Ahmed, Luesley David, Kehoe Sean, Sundar Sudha
Pan Birmingham Gynaecological Cancer Centre, City Hospital, West Midlands, Birmingham, United Kingdom.
Int J Gynecol Cancer. 2015 Nov;25(9):1599-607. doi: 10.1097/IGC.0000000000000551.
Extensive (ultraradical) surgery may facilitate complete cytoreduction in ovarian cancer with potential survival benefit but with greater morbidity. Currently, patient-reported outcomes (PROs) from such surgery are unknown. We conducted the Surgery in Ovarian Cancer Quality of life Evaluation Research study (SOCQER 1), a prospective study investigating the feasibility of collection of serial PROs in patients who had extensive surgery and standard surgery for ovarian cancer.
Ninety-three patients were recruited for 33 months to complete serial PRO assessments using the validated EORTC QLQ-C30 and the ovarian cancer-specific QLQ-OV28 questionnaires preoperatively, at 6 weeks, and at 3, 6, and 9 months postoperatively. Aletti Surgical Complexity Score of 3 or lower was considered standard surgery; a Surgical Complexity Score of 4 or higher was considered extensive surgery. Prospective data collection was obtained from the hospital electronic database, including patient demographics, American Society of Anaesthesiologists grade, preoperative serum CA125 and albumin levels, chemotherapy regimen, and surgical morbidity.
Three cohorts of patients--32 benign, 32 undergoing standard surgery, and 24 undergoing extensive surgery--completed the questionnaires. Median questionnaire completion rate in this study was 64%, demonstrating the feasibility of longitudinal quality of life (QoL) assessment after surgery. Patient-reported outcomes revealed a falling trend in QoL in the short-term (6 weeks-3 months) after surgery, which gradually returned to baseline at 6 to 9 months; this trend was more marked after extensive surgery.
This study provides useful insight into the impact of extensive surgery on patients. Further multicenter studies are needed to evaluate the impact of extensive surgery on patient's QoL and survival.
广泛（超根治性）手术可能有助于卵巢癌实现完全细胞减灭，具有潜在的生存获益，但会带来更高的发病率。目前，此类手术患者报告的结局尚不清楚。我们开展了卵巢癌手术生活质量评估研究（SOCQER 1），这是一项前瞻性研究，旨在调查对接受卵巢癌广泛手术和标准手术的患者收集系列患者报告结局的可行性。
招募93名患者，历时33个月，使用经过验证的欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）和卵巢癌特异性问卷QLQ-OV28，在术前、术后6周以及术后3、6和9个月完成系列患者报告结局评估。Aletti手术复杂性评分为3或更低被视为标准手术；手术复杂性评分为4或更高被视为广泛手术。前瞻性数据收集来自医院电子数据库，包括患者人口统计学资料、美国麻醉医师协会分级、术前血清CA125和白蛋白水平、化疗方案以及手术并发症情况。
三组患者——32名良性疾病患者、32名接受标准手术的患者和24名接受广泛手术的患者——完成了问卷调查。本研究中问卷的中位完成率为64%，表明术后纵向生活质量评估具有可行性。患者报告结局显示，术后短期（6周 - 3个月）生活质量呈下降趋势，在6至9个月时逐渐恢复至基线水平；这种趋势在广泛手术后更为明显。
本研究为广泛手术对患者的影响提供了有益见解。需要进一步开展多中心研究，以评估广泛手术对患者生活质量和生存的影响。
