Faculty of Medicine, Department of Obstetrics and Gynecology, Chiang Mai University, Chiang Mai, Thailand.
Faculty of Medicine, Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand.
J Obstet Gynaecol. 2022 Jan;42(1):139-145. doi: 10.1080/01443615.2021.1877647. Epub 2021 May 2.
We compared the quality of life (QoL) of women with early versus advanced epithelial ovarian cancer and examined predicting factors for the poor QoL. We classified 157 participants into 108 with early disease (stage I-II) and 49 with advanced disease (stage III-IV). They completed two questionnaires: EORTC QLQ-C30 and Chiang Mai University (CMU) ovarian cancer QoL. For EORTC QLQ-C30, the study groups were comparable regarding global health status/QoL, functional scales, and summary scores. The advanced group had worse scores on symptom scales specifically appetite loss and constipation. For CMU Ovarian Cancer QoL, the advanced group had worse scores only in the gastrointestinal domain but not in urinary, lymphatic, and sexual/hormonal domains. These findings remained mostly unchanged after excluding those with recurrence. In multivariable analysis, currently receiving treatment was consistently associated with worse QoL scores. The advanced stage had more adverse impact only on the gastrointestinal domains of QoL, mainly during periods of receiving chemotherapy.IMPACT STATEMENT Survival outcome for women with epithelial ovarian cancer varies depending mainly on stage. Those who survive advanced stage disease could expect long-term disease and treatment-related morbidities that significantly affected QoL. However, there has been very limited information regarding QoL of women who have the early disease in comparison to those with more advanced disease especially in the context of Asian culture. Apart from the higher prevalence of gastrointestinal symptoms reported by the patients with advanced disease, the general well-being and other symptom-specific domains of QoL were comparable between women with early and advanced diseases. Receiving treatment is a consistent predictor for poor QoL. In comparison to early-stage epithelial ovarian cancer, the advanced stage had more adverse impact only on the gastrointestinal domains of QoL, mainly during periods of receiving chemotherapy. This information will be useful for patient counselling. Future research should examine the underlying causes of this finding.
我们比较了早期和晚期上皮性卵巢癌女性的生活质量(QoL),并探讨了生活质量差的预测因素。我们将 157 名参与者分为早期疾病(I-II 期)108 例和晚期疾病(III-IV 期)49 例。他们完成了两个问卷:EORTC QLQ-C30 和清迈大学(CMU)卵巢癌 QoL。对于 EORTC QLQ-C30,研究组在总体健康状况/生活质量、功能量表和综合评分方面具有可比性。晚期组在食欲丧失和便秘等症状量表上的评分较差。对于 CMU 卵巢癌 QoL,晚期组仅在胃肠道领域的评分较差,但在泌尿系统、淋巴系统和性/激素领域的评分没有较差。这些发现在排除复发患者后基本保持不变。在多变量分析中,目前正在接受治疗与较差的 QoL 评分始终相关。晚期阶段仅对生活质量的胃肠道领域产生更不利的影响,主要发生在接受化疗期间。
上皮性卵巢癌患者的生存结果主要取决于分期。那些存活晚期疾病的患者可能会长期出现疾病和治疗相关的并发症,这会严重影响生活质量。然而,与更晚期疾病的患者相比,早期疾病患者的生活质量信息非常有限,特别是在亚洲文化背景下。除了晚期患者报告的胃肠道症状发生率较高外,早期和晚期疾病患者的一般健康状况和其他症状特异性 QoL 领域相当。与早期上皮性卵巢癌相比,仅在接受化疗期间,晚期阶段对生活质量的胃肠道领域有更不利的影响。这些信息将有助于为患者提供咨询。未来的研究应探讨这一发现的根本原因。