Department of Supportive Care Medicine, Moffitt Cancer Center, Tampa, FL, USA.
St. Jude Children's Research Hospital, Memphis, TN, USA.
Support Care Cancer. 2024 Oct 15;32(11):729. doi: 10.1007/s00520-024-08899-0.
We examined post-traumatic reactions and quality of life in women with recurrent gynecologic cancer who underwent a pelvic exenteration (PE), a potentially life-saving radical surgery associated with life-altering sequelae.
Twenty-one women who had completed PE at least 6 months prior completed the Impact of Event Scale-Revised, a measure of post-traumatic stress, the Post-Traumatic Growth Inventory, a measure of post-traumatic growth, the Center for Epidemiologic Studies-Depression Scale, and the European Organization for Research and Treatment of Cancer 30-item core Quality of Life Questionnaire. We examined the associations between these outcome variables, and quality of life scores were compared to normative values for the general and gynecologic cancer populations.
Thirty percent of women reported clinically significant post-traumatic stress symptoms and 71% endorsed clinically significant depressive symptoms. More post-traumatic stress was associated with less post-traumatic growth, more depressive symptoms, and worse quality of life. In general, women's quality of life was worse than the general population but comparable to women with stage III-IV ovarian cancer and women with cervical cancer. Social functioning was markedly lower in our sample and women reported more pain, diarrhea, and financial difficulties post-PE compared to published norms for the general population and women with ovarian or cervical cancer. There were no differences in quality of life based on age, type of PE, type of urinary diversion, or cancer type.
Findings support long-term continued symptom management and the ongoing rehabilitation of patients to optimize physical, psychological, and social well-being in PE survivorship.
我们研究了经历过盆腔廓清术（PE）的复发性妇科癌症女性的创伤后反应和生活质量。PE 是一种可能挽救生命的根治性手术，但会带来改变生活的后遗症。
21 名女性在至少 6 个月前完成了 PE，她们完成了修订后的事件影响量表（IES-R）、创伤后应激障碍量表、创伤后成长量表、流行病学研究中心抑郁量表和欧洲癌症研究与治疗组织 30 项核心生活质量问卷。我们研究了这些结果变量之间的关联，并且将生活质量评分与一般人群和妇科癌症人群的常模进行了比较。
30%的女性报告有临床显著的创伤后应激症状，71%的女性报告有临床显著的抑郁症状。更多的创伤后应激与更少的创伤后成长、更多的抑郁症状和更差的生活质量相关。总的来说，女性的生活质量比一般人群差，但与 III 期或 IV 期卵巢癌和宫颈癌女性相当。我们的样本中社会功能明显较低，与一般人群和卵巢癌或宫颈癌女性的常模相比，女性报告术后更多的疼痛、腹泻和经济困难。生活质量与年龄、PE 类型、尿流改道类型或癌症类型无关。
这些发现支持对患者进行长期持续的症状管理和康复，以优化 PE 生存者的身体、心理和社会幸福感。
