Int J Gynecol Cancer. 2018 May;28(4):818-823. doi: 10.1097/IGC.0000000000001239.
The aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III.
All patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up. Included subjects were interviewed with the European Organization for Research and Treatment of Cancer QLQ-CX24 Questionnaire, European Organization for Research and Treatment of Cancer QLQ-C30, and an Incontinence Impact Questionnaire 7.
From January 2004 to June 2014, 251 patients affected by locally advanced cervical cancer were treated at Campus Bio-Medico of Rome treated with type C2/type III RH. At time point of March 2017, 90 patients were included with a mean age of 55.6 ± 8.5 years. The questionnaires were administered after a median follow-up of 49 months after the end of therapy. The symptoms of fatigue, nausea and vomiting, appetite loss, pain, insomnia, and dyspnea, as well as a negative financial impact, were reported as not frequent and rarely disabling. On the contrary, patients frequently reported gastrointestinal complaints. Diarrhea was present in 6% of patients and was referred as mild; constipation was present in 75% of women and was reported as mild in 30% of cases, moderate in 30%, and severe in 15%. Concerning sexual activity, data indicated a good level of sexual enjoyment with a slight worsening of sexual activity. Incontinence was reported in 28% of cases and appeared to be mild and rarely disabling (all mean values <2).
Waiting for ongoing randomized controlled trials, this study confirmed that RH may be considered as a useful treatment plan, according to its negligible long-term impact on quality of life, urinary dysfunction, and sexual function.
本研究旨在评估先前接受根治性子宫切除术（RH）C2/III 型治疗的长期宫颈癌幸存者的长期生活质量以及尿和性功能。
所有在罗马 Campus Bio-Medico 就诊的因宫颈癌行 RH C2/III 型治疗的患者均符合本回顾性研究方案的纳入标准。我们仅纳入对初始治疗有完全反应且随访时间至少 36 个月的患者。纳入的患者接受了欧洲癌症研究与治疗组织（EORTC）QLQ-CX24 问卷、EORTC QLQ-C30 问卷和尿失禁影响问卷 7（Incontinence Impact Questionnaire 7，ICI-7）的访谈。
2004 年 1 月至 2014 年 6 月，251 例局部晚期宫颈癌患者在罗马 Campus Bio-Medico 接受了 RH C2/III 型治疗。2017 年 3 月，90 例患者符合入组标准，平均年龄为 55.6±8.5 岁。在治疗结束后中位随访 49 个月时进行了问卷调查。疲劳、恶心和呕吐、食欲下降、疼痛、失眠和呼吸困难等症状报告为不频繁且很少致残；相反，患者经常报告胃肠道不适。腹泻的发生率为 6%，为轻度；便秘的发生率为 75%，其中 30%为轻度、30%为中度、15%为重度。关于性行为，数据表明患者有较好的性享受水平，性行为活动略有恶化。尿失禁的发生率为 28%，为轻度，且很少致残（所有平均值均<2）。
在正在进行的随机对照试验的结果公布之前，本研究证实 RH 可被视为一种有用的治疗方案，因其对生活质量、尿功能障碍和性功能的长期影响可忽略不计。
