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使用欧洲癌症研究与治疗组织生活质量问卷核心模块26(EORTC QLQ-TC26)评估睾丸癌幸存者的性功能:一项多机构横断面研究。

Sexual function using the EORTC QLQ-TC26 in testicular cancer survivors: A multi-institutional, cross-sectional study.

作者信息

Koyama Juntaro, Yamashita Shinichi, Kakimoto Kenichi, Uemura Motohide, Kishida Takeshi, Kawai Koji, Nakamura Terukazu, Goto Takayuki, Osawa Takahiro, Nishimura Kazuo, Nonomura Norio, Nishiyama Hiroyuki, Shiraishi Takumi, Ukimura Osamu, Ogawa Osamu, Shinohara Nobuo, Suzukamo Yoshimi, Ito Akihiro, Arai Yoichi

机构信息

Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Department of Urology, Osaka International Cancer Institute, Osaka, Osaka, Japan.

出版信息

Int J Urol. 2023 Nov;30(11):1044-1050. doi: 10.1111/iju.15262. Epub 2023 Jul 31.

Abstract

OBJECTIVE

To evaluate sexual function after treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Testicular Cancer 26 (EORTC QLQ-TC26) questionnaire in Japanese testicular cancer (TC) survivors in a multi-institutional, cross-sectional study.

METHODS

This study enrolled TC survivors who visited any of eight high-volume institutions in Japan from 2018 to 2019. After obtaining informed consent, participants completed the EORTC QLQ-TC26 questionnaires. We evaluated sexual function after treatment for TC using the EORTC QLQ-TC26 and analyzed the impact of treatment on sexual function in TC survivors.

RESULTS

A total of 567 TC survivors responded to the EORTC QLQ-TC26. Median age at the time of response was 43 years (interquartile range [IQR] 35-51 years), and median follow-up period after treatment was 5.2 years (IQR 2.2-10.0 years). Sexual function, particularly ejaculatory function, was significantly lower after post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) than after Surveillance or Chemotherapy groups (p < 0.05). In the PC-RPLND group, nerve-sparing procedure preserved postoperative ejaculatory function after RPLND compared with the non-nerve-sparing and offered improved ejaculatory function with time. On multivariate analysis, RPLND was a significant predictor of post-treatment ejaculatory dysfunction, particularly without nerve-sparing (odds ratio 3.0, 95% CI 1.2-7.7, p < 0.05). In addition, TC survivors with nerve-sparing RPLND had higher sexual activity than those without.

CONCLUSION

This survey of the EORTC QLQ-TC26 showed that sexual function and activity in TC survivors after RPLND was reduced in the absence of nerve-sparing techniques.

摘要

目的

在一项多机构横断面研究中,使用欧洲癌症研究与治疗组织生活质量问卷 - 睾丸癌26(EORTC QLQ - TC26)问卷评估日本睾丸癌(TC)幸存者治疗后的性功能。

方法

本研究纳入了2018年至2019年期间前往日本八家大型机构中任何一家就诊的TC幸存者。在获得知情同意后,参与者完成EORTC QLQ - TC26问卷。我们使用EORTC QLQ - TC26评估TC治疗后的性功能,并分析治疗对TC幸存者性功能的影响。

结果

共有567名TC幸存者对EORTC QLQ - TC26做出了回应。回应时的中位年龄为43岁(四分位间距[IQR] 35 - 51岁),治疗后的中位随访期为5.2年(IQR 2.2 - 10.0年)。化疗后腹膜后淋巴结清扫术(PC - RPLND)后的性功能,尤其是射精功能,显著低于监测或化疗组(p < 0.05)。在PC - RPLND组中,与非保留神经手术相比,保留神经手术保留了RPLND术后的射精功能,并随着时间推移改善了射精功能。多因素分析显示,RPLND是治疗后射精功能障碍的显著预测因素,尤其是非保留神经手术(比值比3.0,95%置信区间1.2 - 7.7,p < 0.05)。此外,接受保留神经RPLND的TC幸存者的性活动高于未接受者。

结论

这项对EORTC QLQ - TC26的调查表明,在缺乏保留神经技术的情况下,RPLND后TC幸存者的性功能和性活动会降低。

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