Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
J Sex Med. 2022 Apr;19(4):613-619. doi: 10.1016/j.jsxm.2022.01.519. Epub 2022 Feb 25.
Cervical cancer survivors report the worst quality of life (QoL) among all cancer survivors and this is mainly due to their younger age and the long-term treatment sequelae.
The purpose of this study is to assess the long-term QoL and sexual function of locally advanced cervical cancer (LACC) patients treated with neoadjuvant chemotherapy (NACT) and radical hysterectomy (RH) instead of the standard chemoradiotherapy.
This is a retrospective case-control study including LACC patients (FIGO stage IIB-IVA) treated with the NACT-RH strategy and a control group of healthy women undergoing hysterectomy for uterine fibromatosis in the same period.
Main outcome measures were the EORTC QLQ-C30 and EORTC QLQ-CX24 for quality of life and Female Sexual Function Index (FSFI) for sexual function.
Overall, 96 patients were included: 48 LACC and 48 controls. The mean age at diagnosis was 45.5 ± 9.0 and 47.0 ± 7.8, respectively (P = .38). Compared to controls, LACC patients reported lower mean scores for the global health status (69.4 ± 22.6 vs 81.2 ± 24.3; Mean Difference (MD): -11.80 [95% CI: -21.19, -2.41]; P = .016), QLQ-C30 functional scale (80.1 ± 22.6 vs 92.4 ± 14.9; MD: -12.30 [95% CI: -19.96, -4.64]; P = .002), QLQ-Cx24 functional scale (55.5 ± 25.0 vs 80.4 ± 22.4; MD: -24.00 [95% CI: -34.40, -15.40]; P < .001), and the total FSFI (19.3 ± 9.6 vs 26.2 ± 9.9; MD: -6.90 [95% CI: -10.80, -3.00]; P < .001). On the other hand, LACC patients reported higher mean scores on the QLQ-C30 (16.9 ± 22.1 vs 8.4 ± 16.6; MD: 8.50 [95% CI: 0.68, 16.32]; P = .03) and QLQ-CX24 (26.0 ± 28.8 vs 15.0 ± 11.7; MD: 11.00 [95% CI: -2.21, 19.79]; P = .01) symptoms scales.
The confirmed poor quality of life even in surgically treated LACC survivors underlines the importance of tailoring parametrectomy based on lymph node status and developing personalized strategies.
The study assessed the long-term QoL and sexual function in the specific subpopulation of LACC patients treated with NACT-RH. Main limitations include the small sample size and the retrospective design.
LACC long-term survivors treated with NACT-RH experience poor QoL and sexual dysfunction. Palaia I, Santangelo G, Caruso G, et al. Long-term Quality of Life and Sexual Function After Neoadjuvant Chemotherapy and Radical Surgery for Locally Advanced Cervical Cancer. J Sex Med 2022;19:613-619.
宫颈癌幸存者的生活质量（QoL）是所有癌症幸存者中最差的，这主要是由于她们年龄较轻和长期治疗的后遗症。
本研究旨在评估局部晚期宫颈癌（LACC）患者接受新辅助化疗（NACT）和根治性子宫切除术（RH）治疗而不是标准放化疗的长期 QoL 和性功能。
这是一项回顾性病例对照研究，包括接受 NACT-RH 策略治疗的 LACC 患者（FIGO 分期 IIB-IVA）和同期因子宫肌瘤接受子宫切除术的健康女性对照组。
主要观察指标为 EORTC QLQ-C30 和 EORTC QLQ-CX24 用于生活质量和女性性功能指数（FSFI）用于性功能。
共纳入 96 例患者：48 例 LACC 和 48 例对照。诊断时的平均年龄分别为 45.5 ± 9.0 和 47.0 ± 7.8（P =.38）。与对照组相比，LACC 患者报告的总体健康状况评分较低（69.4 ± 22.6 vs 81.2 ± 24.3；平均差异（MD）：-11.80 [95% CI：-21.19，-2.41]；P =.016），QLQ-C30 功能量表（80.1 ± 22.6 vs 92.4 ± 14.9；MD：-12.30 [95% CI：-19.96，-4.64]；P =.002），QLQ-Cx24 功能量表（55.5 ± 25.0 vs 80.4 ± 22.4；MD：-24.00 [95% CI：-34.40，-15.40]；P <.001）和总 FSFI（19.3 ± 9.6 vs 26.2 ± 9.9；MD：-6.90 [95% CI：-10.80，-3.00]；P <.001）。另一方面，LACC 患者报告的 QLQ-C30（16.9 ± 22.1 vs 8.4 ± 16.6；MD：8.50 [95% CI：0.68，16.32]；P =.03）和 QLQ-CX24（26.0 ± 28.8 vs 15.0 ± 11.7；MD：11.00 [95% CI：-2.21，19.79]；P =.01）症状量表的评分较高。
即使在接受 NACT-RH 治疗的 LACC 幸存者中也确认了生活质量差，这强调了根据淋巴结状态定制广泛子宫切除术和制定个性化策略的重要性。
本研究评估了接受 NACT-RH 治疗的 LACC 特定亚群的长期 QoL 和性功能。主要局限性包括样本量小和回顾性设计。
接受 NACT-RH 治疗的 LACC 长期幸存者经历了较差的 QoL 和性功能障碍。
