Meltzer-Gunnes Christin Julia, Hagen Milada C, Wang Yun, Jensen Pernille T, Vistad Ingvild
Department of Obstetrics and Gynecology, Sorlandet Hospital HF, Kristiansand, Norway.
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Obstet Gynecol Scand. 2025 Aug;104(8):1505-1516. doi: 10.1111/aogs.15155. Epub 2025 May 14.
Vulvar cancer survivors are at risk of experiencing impaired health-related quality of life and sexual functioning after treatment. However, studies on survivorship challenges, particularly several years after treatment, are scarce. Our aim was to assess health-related quality of life in Norwegian vulvar cancer survivors more than 5 years after treatment and to compare reported vulvar symptoms and sexual functioning with women from a normative sample of the general Norwegian female population.
Patients treated primarily for early-stage vulvar squamous cell carcinoma at the Norwegian Radium Hospital between 2006 and 2016 were invited to participate. Health-related quality of life, vulvar symptoms, and sexual functioning were assessed using the EORTC QLQ-C30 and EORTC QLQ-VU34. To recruit a normative sample, the EORTC QLQ-VU34 was also distributed to a sample of Norwegian women with no prior history of cancer. EORTC QLQ-C30 scores among vulvar cancer survivors were compared to "thresholds for clinical importance." EORTC QLQ-VU34 scores among cancer survivors were compared to those of the normative sample.
A total of 44 (57%) of 77 vulvar cancer survivors completed the questionnaires, and 334 women from the general population were included for the normative sample. A considerable proportion of cancer survivors reported clinically relevant problems: 43% reported impaired physical functioning, while 30% experienced impaired emotional, cognitive, and social functioning. Genital and groin symptoms were significantly more common among cancer survivors than among women in the normative sample. Fewer vulvar cancer survivors were sexually active (9/44 (20%) versus 232/334 (69%)) and they reported a higher degree of sexual dysfunction compared to the normative sample.
Vulvar cancer survivors reported impaired health-related quality of life even several years after treatment. Vulvar complaints and impaired sexual functioning were more common among vulvar cancer survivors than among women from the normative sample.
外阴癌幸存者在治疗后有健康相关生活质量受损和性功能障碍的风险。然而，关于生存挑战的研究，尤其是治疗数年之后的研究很少。我们的目的是评估挪威外阴癌幸存者治疗5年以上的健康相关生活质量，并将报告的外阴症状和性功能与挪威女性普通人群的规范样本进行比较。
邀请2006年至2016年期间在挪威镭医院主要接受早期外阴鳞状细胞癌治疗的患者参与。使用欧洲癌症研究与治疗组织核心生活质量问卷（EORTC QLQ-C30）和欧洲癌症研究与治疗组织外阴癌特异性问卷（EORTC QLQ-VU34）评估健康相关生活质量、外阴症状和性功能。为招募规范样本，EORTC QLQ-VU34也分发给了无癌症病史的挪威女性样本。将外阴癌幸存者的EORTC QLQ-C30得分与“临床重要性阈值”进行比较。将癌症幸存者的EORTC QLQ-VU34得分与规范样本的得分进行比较。
77名外阴癌幸存者中有44名（57%）完成了问卷调查，334名普通人群女性被纳入规范样本。相当一部分癌症幸存者报告了临床相关问题：43%报告身体功能受损，30%经历情绪、认知和社会功能受损。癌症幸存者中生殖器和腹股沟症状明显比规范样本中的女性更常见。外阴癌幸存者中性生活活跃的较少（9/44（20%）对232/334（69%）），与规范样本相比，他们报告的性功能障碍程度更高。
外阴癌幸存者即使在治疗数年之后仍报告健康相关生活质量受损。外阴癌幸存者中外阴不适和性功能障碍比规范样本中的女性更常见。
