1 Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center , New York, New York.
2 Department of Obstetrics and Gynecology, Weill Cornell Medical College , New York, New York.
J Womens Health (Larchmt). 2018 Mar;27(3):387-393. doi: 10.1089/jwh.2016.6208. Epub 2017 Dec 21.
To assess the emotional, reproductive, sexual health, and relationship concerns of women treated for gestational trophoblastic neoplasia (GTN) and examine associations with ß-hCG surveillance.
This institutional review board approved study surveyed GTN survivors (n = 51) who received treatment from 1996 to 2008. Fifty-one women, including those actively followed or formerly treated, were surveyed. The survey consisted of background/medical information, the Reproductive Concerns Scale, the Female Sexual Function Index, an item from the Abbreviated Dyadic Adjustment Scale, the Center for Epidemiologic Studies-Depression scale, the Menopausal Symptom Checklist, the Impact of Life Events Scale, and exploratory items.
Mean age at diagnosis was 37.1 years; 41.6 years at study enrollment. Twenty-seven patients (56%) expressed worry about treatment harm and 30 (60%) about recurrence. Twenty percent reported significant depressive symptomatology. Mild cancer-related distress, reproductive concerns, sexual dysfunction, and bothersome menopausal symptoms were noted. Nineteen patients (40%) rated their ß-hCG surveillance worry as "high." Among patients who attempted conception after treatment, 3 of 12 (25%) succeeded in the ß-hCG high-worry group versus 13 of 19 (68%) in the ß-hCG low-worry group. Survivors with high ß-hCG worry had greater reproductive concerns than those with low worry (p = 0.002) and reported less sexual desire (p = 0.025). There was no difference in the number of low-worry versus high-worry participants in active surveillance (p = 0.09).
Our study suggests that cancer-specific distress, sexual health, and reproductive concerns continue to impact women years after treatment. High worry about ß-hCG surveillance is negatively associated with the emotional well-being of GTN survivors and possibly influences reproductive attempts and success.
评估接受妊娠滋养细胞肿瘤（GTN）治疗的女性的情绪、生殖、性健康和关系问题，并检查这些问题与β-hCG 监测之间的关联。
本机构审查委员会批准了这项研究，调查了 1996 年至 2008 年期间接受治疗的 GTN 幸存者（n=51）。对 51 名女性进行了调查，包括正在接受随访或以前接受过治疗的女性。调查包括背景/医学信息、生殖关注量表、女性性功能指数、简短夫妻适应量表的一个项目、流行病学研究中心抑郁量表、更年期症状检查表、生活事件影响量表和探索性项目。
诊断时的平均年龄为 37.1 岁；研究入组时的平均年龄为 41.6 岁。27 名患者（56%）对治疗危害表示担忧，30 名（60%）对复发表示担忧。20%的患者报告有明显的抑郁症状。轻度与癌症相关的痛苦、生殖关注、性功能障碍和烦人的更年期症状被注意到。19 名患者（40%）将其β-hCG 监测担忧评为“高”。在治疗后尝试怀孕的患者中，β-hCG 高担忧组的 3 例（25%）成功，β-hCG 低担忧组的 13 例（68%）成功。β-hCG 担忧程度高的幸存者比担忧程度低的幸存者有更多的生殖关注（p=0.002），性欲较低（p=0.025）。在主动监测中，低担忧组与高担忧组的参与者人数没有差异（p=0.09）。
我们的研究表明，癌症特异性痛苦、性健康和生殖关注在治疗后多年仍会影响女性。β-hCG 监测的高度担忧与 GTN 幸存者的情绪健康呈负相关，并可能影响生殖尝试和成功。
