Derks Marloes, van der Velden Jacobus, Frijstein Minke M, Vermeer Willemijn M, Stiggelbout Anne M, Roovers Jan Paul W R, de Kroon Cornelis D, Ter Kuile Moniek M, Kenter Gemma G
*Department of Gynaecologic Oncology, Academic Medical Center-Centre for Gynaecological Oncology, Amsterdam; Departments of †Clinical Psychology, ‡Medical Decision Making, and §Gynaecologic Oncology, Leiden University Medical Center, Leiden, the Netherlands.
Int J Gynecol Cancer. 2016 Oct;26(8):1538-43. doi: 10.1097/IGC.0000000000000776.
This study aimed to compare urinary and bowel symptoms and quality of life (QoL) among women treated with a Wertheim-Meigs (WM, type III) or Wertheim-Okabayashi (WO, type IV) radical hysterectomy with pelvic lymphadenectomy for early-stage cervical cancer.
In this cross-sectional observational study, patients treated with a WO or a (nerve sparing) WM radical hysterectomy (with or without adjuvant radiotherapy) between January 2000 and December 2010 in the Center for Gynaecological Oncology Amsterdam or Leiden University Medical Center were included. To assess QoL, urinary and bowel symptoms we used the EORTC QLQ-C30, EORTC QLQ-CX24, and Leiden Questionnaire. We performed a multivariate analysis to identify factors associated with urinary symptoms.
Two hundred sixty-eight women were included (152 WO and 116 WM). Quality of life was not significantly different in patients treated by WO or WM. Urinary symptoms were more often reported by patients in the WO group compared to the WM group: "feeling of urine retention" (53% vs 32%), "feeling less/no urge to void" (59% vs 14%), and "timed voiding" (49% vs 10%). With regard to bowel symptoms, there was no difference between both. Multivariate analysis showed that surgical technique was an independent factor for differences in urinary symptoms.
Patients undergoing more radical surgery for early-stage cervical cancer report significantly more urinary dysfunction, whereas bowel function and health-related QoL are not decreased.
本研究旨在比较接受韦特海姆-梅格斯（WM，III型）或韦特海姆-冈林（WO，IV型）根治性子宫切除术加盆腔淋巴结清扫术治疗的早期宫颈癌女性的泌尿和肠道症状及生活质量（QoL）。
在这项横断面观察性研究中，纳入了2000年1月至2010年12月期间在阿姆斯特丹妇科肿瘤中心或莱顿大学医学中心接受WO或（保留神经的）WM根治性子宫切除术（有或无辅助放疗）的患者。为评估生活质量、泌尿和肠道症状，我们使用了欧洲癌症研究与治疗组织生活质量问卷核心30项模块（EORTC QLQ-C30）、欧洲癌症研究与治疗组织宫颈癌特异性问卷（EORTC QLQ-CX24）和莱顿问卷。我们进行了多变量分析以确定与泌尿症状相关的因素。
共纳入268名女性（152名接受WO手术，116名接受WM手术）。接受WO或WM治疗的患者生活质量无显著差异。与WM组相比，WO组患者更常报告泌尿症状：“尿潴留感”（53%对32%）、“排尿冲动减少/无排尿冲动”（59%对14%）和“定时排尿”（49%对10%）。关于肠道症状，两组之间没有差异。多变量分析表明手术技术是泌尿症状差异的独立因素。
接受更根治性手术治疗早期宫颈癌的患者报告的泌尿功能障碍明显更多，而肠道功能和与健康相关的生活质量并未下降。
