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手术后子宫内膜癌、宫颈癌和卵巢癌患者的绝经期症状:一项横断面研究。

Climacteric symptoms in postoperative patients among endometrial cancer, cervical cancer, and ovarian cancer: a cross-sectional study.

机构信息

Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Center for Kampo Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

出版信息

Support Care Cancer. 2022 Aug;30(8):6785-6793. doi: 10.1007/s00520-022-07117-z. Epub 2022 May 8.

Abstract

PURPOSE

To date, no studies have assessed climacteric symptoms after hystero-adnexectomy for endometrial, cervical, or ovarian cancer. Thus, this study aimed to compare climacteric symptoms among patients who underwent surgery for these three cancer types.

METHODS

In this cross-sectional study, we interviewed patients who were registered at a menopausal outpatient clinic between January 1999 and July 2016 after undergoing total hysterectomy, intrapelvic only or intrapelvic plus para-aortic lymph node dissection, and bilateral adnexectomy performed via laparotomy as a cancer treatment. Climacteric symptoms were assessed using a patient-reported questionnaire covering core domains with five symptoms only at the initial consultation. Each symptom was graded from 0 (no symptoms) to 3 (severe symptoms). We evaluated the frequency of symptom severity according to the time elapsed since surgery and the cancer type.

RESULTS

The numbers of patients with endometrial, ovarian, and cervical cancer were 328, 90, and 107, respectively. Overall, climacteric symptoms were more severe in patients with cervical cancer than in those with endometrial or ovarian cancer; symptom severity decreased with increasing time since surgery. However, symptom severity did not decrease significantly over time in patients with cervical cancer even after > 5 years had elapsed since surgery.

CONCLUSION

The climacteric symptoms were less severe in patients with endometrial or ovarian cancer with longer time elapsed since surgery but not in those with cervical cancer. Patients with cervical cancer may require more prompt interventions, including symptomatic treatment and longer follow-up period, than those with endometrial or ovarian cancer.

摘要

目的

迄今为止,尚无研究评估因子宫内膜癌、宫颈癌或卵巢癌而行子宫附件切除术患者的更年期症状。因此,本研究旨在比较这三种癌症类型患者的更年期症状。

方法

在这项横断面研究中,我们对 1999 年 1 月至 2016 年 7 月间在更年期门诊就诊的患者进行了采访,这些患者接受了全子宫切除术、单纯盆腔内或盆腔内加腹主动脉旁淋巴结清扫术,以及经剖腹术行双侧附件切除术,这些手术均为癌症治疗手段。使用患者报告问卷评估更年期症状,问卷涵盖核心领域,仅在初始就诊时评估 5 种症状。每个症状的严重程度分为 0(无症状)至 3(严重症状)。我们根据手术时间和癌症类型评估了症状严重程度的发生频率。

结果

子宫内膜癌、卵巢癌和宫颈癌患者的数量分别为 328、90 和 107 例。总体而言,宫颈癌患者的更年期症状比子宫内膜癌或卵巢癌患者更严重;随着手术时间的延长,症状严重程度降低。然而,即使在手术后 5 年以上,宫颈癌患者的症状严重程度并未随时间的推移而显著降低。

结论

对于手术时间较长的子宫内膜癌或卵巢癌患者,更年期症状的严重程度较轻,但对于宫颈癌患者则并非如此。与子宫内膜癌或卵巢癌患者相比,宫颈癌患者可能需要更及时的干预,包括症状治疗和更长的随访期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbff/9213383/cad0afab885b/520_2022_7117_Fig1_HTML.jpg

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