Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark; Faculty of Health Sciences, Clinical Institute, University of Southern Denmark, Odense, Denmark.
Faculty of Health Sciences, Clinical Institute, University of Southern Denmark, Odense, Denmark; Department of Pelvic Cancer, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Gynecol Oncol. 2019 May;153(2):271-276. doi: 10.1016/j.ygyno.2019.02.006. Epub 2019 Feb 23.
To assess early recovery of physical health after robotic minimally invasive surgery (RMIS) for early-stage endometrial cancer using the European Organisation of Research and Treatment of Cancer Computer Adaptive Test Core questionnaire (EORTC CAT Core). The EORTC CAT Core provides individualised measurements while maintaining comparability. A hypothesis of individual complete recovery to baseline within three post-surgical weeks was evaluated.
Ninety-four women who underwent RMIS for early-stage endometrial cancer were included consecutively. The EORTC CAT Core was distributed before surgery and prospectively every week during the first post-operative month. Repeated measures models were fitted for each of the four domains (physical functioning, role function, fatigue, and pain) and tested for impact of age, ASA score, minor/major surgery, and the individual baseline scores (poorest, intermediate, best).
Women with the lowest physical functioning, lowest role function, highest fatigue level, and highest pain level at baseline all recovered within three weeks. Women with the highest physical functioning, highest role function, lowest level of fatigue, and lowest level of pain at baseline did not reach their individual baselines within the first post-operative month but had the most favourable domain-scores three weeks post-operatively.
The individual woman's physical health baseline score is predictive for her postoperative recovery following RMIS for early-stage endometrial cancer. Women with the best physical health had the best postoperative functions and lowest level of symptoms; however their recovery to baseline was prolonged. Computer adaptive testing may be a valuable tool for individualised pre-operative information and supportive care during surveillance.
使用欧洲癌症研究与治疗组织计算机自适应测试核心问卷（EORTC CAT Core）评估早期子宫内膜癌机器人微创手术（RMIS）后身体康复的早期情况。EORTC CAT Core 提供个性化测量，同时保持可比性。评估了假设术后 3 周内个体完全恢复到基线的情况。
连续纳入 94 例行 RMIS 治疗早期子宫内膜癌的女性。EORTC CAT Core 在术前和术后第一个月每周前瞻性发放。对每个四个领域（身体功能、角色功能、疲劳和疼痛）进行重复测量模型拟合，并测试年龄、ASA 评分、小手术/大手术和个体基线评分（最差、中等、最佳）的影响。
基线时身体功能最差、角色功能最差、疲劳程度最高和疼痛程度最高的女性均在 3 周内恢复。基线时身体功能最好、角色功能最好、疲劳程度最低、疼痛程度最低的女性在术后第一个月内没有达到个人基线，但术后 3 周的功能评分最有利。
个体的身体健康基线评分是预测 RMIS 治疗早期子宫内膜癌术后恢复的指标。身体健康状况最好的女性术后功能最好，症状最低；但她们的恢复到基线时间延长。计算机自适应测试可能是个性化术前信息和监测期间支持性护理的有价值工具。
