Nieuwenhuyzen-de Boer Gatske M, Aamran Hanane, van den Berg Caroline B, Willemsen Sten, Piek Jurgen M J, Reesink-Peters Nathalie, Maliepaard Marianne, van Doorn Helena C, Polinder Suzanne, van Beekhuizen Heleen J
Department of Gynecologic Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands.
Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, 3318 AT Dordrecht, The Netherlands.
Cancers (Basel). 2023 Aug 3;15(15):3947. doi: 10.3390/cancers15153947.
Knowledge of quality-of-life after cytoreductive surgery is important to counsel patients with advanced-stage epithelial ovarian cancer prior to surgery. The aim of this study was to determine whether the use of the PlasmaJet Surgical device during cytoreductive surgery has an effect on the quality-of-life of patients with advanced epithelial ovarian cancer.
Data included in this prospective observational study were derived from the PlaComOv study, in which patients with advanced epithelial ovarian cancer were randomly assigned to have cytoreductive surgery with or without adjuvant use of the PlasmaJet. Quality-of-life was measured before surgery and one, six, 12, and 24 months after surgery with three questionnaires: the EORTC QLQ-C30, QLQ-OV28, and EQ-5D-5L.
Between 2018 and 2020, 326 patients were enrolled in the trial. The overall response rate was high, with the lowest response rate at 24 months of 77%. At 6 months, quality-of-life was higher in the intervention group (95%CI 0.009; 0.081, = 0.045). At 12 months, quality-of-life was higher in the intervention group with fewer symptoms of fatigue, appetite loss, and diarrhea (95%CI 0.6; 10,0, = 0.027); similarly, patients in the intervention group reported a better body image (95%CI -14.2; -3.0, = 0.003) and a higher score on the visual analog scale (95%CI 1.99; 11.15, = 0.005). At 24 months postoperatively, no further difference was found between the two groups except for pain (95%CI -12.9; -0.8, = 0.027) and body image (95%CI -13.808; -0.733, = 0.029). A higher quality-of-life in the intervention group was partially explained by the mediator 'surgery outcome'.
This study demonstrated knowledge of patients' quality-of-life until two years after cytoreductive surgery. The use of the PlasmaJet Surgical device during cytoreductive surgery leads to a higher quality-of-life than conventional surgery with electrocoagulation alone. Even after adjustment for the mediator of surgical outcome, a higher quality-of-life was seen in patients who had surgery with the use of the PlasmaJet device.
在对晚期上皮性卵巢癌患者进行术前咨询时，了解减瘤手术后的生活质量很重要。本研究的目的是确定在减瘤手术中使用PlasmaJet Surgical设备是否会对晚期上皮性卵巢癌患者的生活质量产生影响。
这项前瞻性观察性研究纳入的数据来自PlaComOv研究，在该研究中，晚期上皮性卵巢癌患者被随机分配接受减瘤手术，术中是否辅助使用PlasmaJet。在手术前以及术后1个月、6个月、12个月和24个月，使用三份问卷对生活质量进行测量：欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）、卵巢癌特异性生活质量问卷（QLQ-OV28）和欧洲五维度健康量表（EQ-5D-5L）。
2018年至2020年期间，326例患者参与了该试验。总体应答率较高，24个月时的最低应答率为77%。在6个月时，干预组的生活质量更高（95%置信区间0.009；0.081，P = 0.045）。在12个月时，干预组的生活质量更高，疲劳、食欲减退和腹泻症状更少（95%置信区间0.6；10.0，P = 0.027）；同样，干预组患者报告身体形象更好（95%置信区间-14.2；-3.0，P = 0.003），视觉模拟量表得分更高（95%置信区间1.99；11.15，P = 0.005）。术后24个月时，除疼痛（95%置信区间-12.9；-0.8，P = 0.027）和身体形象（95%置信区间-13.808；-0.733，P = 0.029）外，两组之间未发现进一步差异。干预组较高的生活质量部分可由中介因素“手术结果”解释。
本研究展示了减瘤手术后两年内患者的生活质量情况。在减瘤手术中使用PlasmaJet Surgical设备比单纯使用电凝的传统手术能带来更高的生活质量。即使在对手术结果这一中介因素进行调整后，使用PlasmaJet设备进行手术的患者仍具有更高的生活质量。
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