Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis
Identifieur interne : 002A47 ( Pmc/Curation ); précédent : 002A46; suivant : 002A48Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis
Auteurs : Giovanna Mantegna [Italie] ; Marco Petrillo [Italie] ; Gilda Fuoco [Italie] ; Laura Venditti [Italie] ; Serena Terzano [Italie] ; Luigi Pedone Anchora [Italie] ; Giovanni Scambia [Italie] ; Gabriella Ferrandina [Italie]Source :
- BMC Cancer [ 1471-2407 ] ; 2013.
Abstract
A long-term prospective assessment of QoL in cervical cancer patients is still lacking. Here, we provide the first 2-years prospective, longitudinal study evaluating emotional distress and QoL in early stage (ECC) and locally advanced (LACC) cervical cancer patients who remained disease-free 2-years from diagnosis.
The questionnaires: Hospital Anxiety and Depression Scale (HADS), Global Health Status items of EORTC QLQ-C30 (GHS), and EORTC QLQ-CX24 (CX24) have been administered by a dedicated team of psycho-oncologists, administered at baseline, and after 3, 6, 12 and 24 months from surgery The Generalized Linear Model for repeated measure was used to analyze modifications of QoL measures over time.
In both groups, an early reduction of the percentage of patients with anxiety levels ≥11 was observed at the 3-month evaluation (ECC: 25.7% at baseline Vs 14.7% after 3 months, p value=0.001; LACC: 22.2% at baseline Vs 15.4% after 3 months, p value=0.001). Despite this favorable trend, after 2 years from diagnosis, 11.9% of ECC and 15.6% of LACC patients still showed an anxiety score ≥11. No significant changes over time were observed in term of Depression levels. Focusing on QoL issues, mean GHS and Sexual Activity scores showed an improvement over time in both groups compared to baseline (GHS: 5.7% difference for ECC, p value=0.001, and 11.0% in LACC, p value=0.001; SXA: 13.9% difference for ECC, p value=0.001; and 6.1% in LACC, p value=0.008). On the other hand, Body Image mean scores were significantly impaired by chemoradiation administration in LACC patients, without long-term recovery (7.5% difference, p value=0.001). Finally, in both groups, lymphedema (LY) and menopausal symptoms (MS) showed an early worsening which persisted 2-year after surgery (LY: 19.5% difference for ECC, p value=0.014, and 27.3% in LACC, p value=0.001; MS: 14.4% difference for ECC, p value=0.004, and 16.0% in LACC, p value=0.002).
Despite a significant improvement over time, elevated anxiety levels are still detectable at 24 months after surgery in approximately 10% of cervical cancer patients. Much more attention should be focused on surgical/medical approaches able to minimize the negative impact of lymphedema and menopausal symptoms on QoL.
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DOI: 10.1186/1471-2407-13-127
PubMed: 23506235
PubMed Central: 3608958
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xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author><author><name sortKey="Fuoco, Gilda" sort="Fuoco, Gilda" uniqKey="Fuoco G" first="Gilda" last="Fuoco">Gilda Fuoco</name><affiliation wicri:level="1"><nlm:aff id="I3">Gynecologic Oncology Unit, Department of Oncology, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Gynecologic Oncology Unit, Department of Oncology, Catholic University, Campobasso</wicri:regionArea></affiliation></author><author><name sortKey="Venditti, Laura" sort="Venditti, Laura" uniqKey="Venditti L" first="Laura" last="Venditti">Laura Venditti</name><affiliation wicri:level="1"><nlm:aff id="I1">Psycho-Oncology Service, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Psycho-Oncology Service, Catholic University, 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sortKey="Scambia, Giovanni" sort="Scambia, Giovanni" uniqKey="Scambia G" first="Giovanni" last="Scambia">Giovanni Scambia</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author><author><name sortKey="Ferrandina, Gabriella" sort="Ferrandina, Gabriella" uniqKey="Ferrandina G" first="Gabriella" last="Ferrandina">Gabriella Ferrandina</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, 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first="Giovanna" last="Mantegna">Giovanna Mantegna</name><affiliation wicri:level="1"><nlm:aff id="I1">Psycho-Oncology Service, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Psycho-Oncology Service, Catholic University, Campobasso</wicri:regionArea></affiliation></author><author><name sortKey="Petrillo, Marco" sort="Petrillo, Marco" uniqKey="Petrillo M" first="Marco" last="Petrillo">Marco Petrillo</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author><author><name sortKey="Fuoco, Gilda" sort="Fuoco, Gilda" uniqKey="Fuoco G" first="Gilda" last="Fuoco">Gilda Fuoco</name><affiliation wicri:level="1"><nlm:aff id="I3">Gynecologic Oncology Unit, Department of Oncology, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Gynecologic Oncology Unit, Department of Oncology, Catholic University, Campobasso</wicri:regionArea></affiliation></author><author><name sortKey="Venditti, Laura" sort="Venditti, Laura" uniqKey="Venditti L" first="Laura" last="Venditti">Laura Venditti</name><affiliation wicri:level="1"><nlm:aff id="I1">Psycho-Oncology Service, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Psycho-Oncology Service, Catholic University, Campobasso</wicri:regionArea></affiliation></author><author><name sortKey="Terzano, Serena" sort="Terzano, Serena" uniqKey="Terzano S" first="Serena" last="Terzano">Serena Terzano</name><affiliation wicri:level="1"><nlm:aff id="I1">Psycho-Oncology Service, Catholic University, Campobasso, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Psycho-Oncology Service, Catholic University, Campobasso</wicri:regionArea></affiliation></author><author><name sortKey="Anchora, Luigi Pedone" sort="Anchora, Luigi Pedone" uniqKey="Anchora L" first="Luigi Pedone" last="Anchora">Luigi Pedone Anchora</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author><author><name sortKey="Scambia, Giovanni" sort="Scambia, Giovanni" uniqKey="Scambia G" first="Giovanni" last="Scambia">Giovanni Scambia</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author><author><name sortKey="Ferrandina, Gabriella" sort="Ferrandina, Gabriella" uniqKey="Ferrandina G" first="Gabriella" last="Ferrandina">Gabriella Ferrandina</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Cancer</title><idno type="eISSN">1471-2407</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>A long-term prospective assessment of QoL in cervical cancer patients is still lacking. Here, we provide the first 2-years prospective, longitudinal study evaluating emotional distress and QoL in early stage (ECC) and locally advanced (LACC) cervical cancer patients who remained disease-free 2-years from diagnosis.</p></sec><sec><title>Methods</title><p>The questionnaires: Hospital Anxiety and Depression Scale (HADS), Global Health Status items of EORTC QLQ-C30 (GHS), and EORTC QLQ-CX24 (CX24) have been administered by a dedicated team of psycho-oncologists, administered at baseline, and after 3, 6, 12 and 24 months from surgery The Generalized Linear Model for repeated measure was used to analyze modifications of QoL measures over time.</p></sec><sec><title>Results</title><p>In both groups, an early reduction of the percentage of patients with anxiety levels ≥11 was observed at the 3-month evaluation (ECC: 25.7% at baseline Vs 14.7% after 3 months, p value=0.001; LACC: 22.2% at baseline Vs 15.4% after 3 months, p value=0.001). Despite this favorable trend, after 2 years from diagnosis, 11.9% of ECC and 15.6% of LACC patients still showed an anxiety score ≥11. No significant changes over time were observed in term of Depression levels. Focusing on QoL issues, mean GHS and Sexual Activity scores showed an improvement over time in both groups compared to baseline (GHS: 5.7% difference for ECC, p value=0.001, and 11.0% in LACC, p value=0.001; SXA: 13.9% difference for ECC, p value=0.001; and 6.1% in LACC, p value=0.008). On the other hand, Body Image mean scores were significantly impaired by chemoradiation administration in LACC patients, without long-term recovery (7.5% difference, p value=0.001). Finally, in both groups, lymphedema (LY) and menopausal symptoms (MS) showed an early worsening which persisted 2-year after surgery (LY: 19.5% difference for ECC, p value=0.014, and 27.3% in LACC, p value=0.001; MS: 14.4% difference for ECC, p value=0.004, and 16.0% in LACC, p value=0.002).</p></sec><sec><title>Conclusions</title><p>Despite a significant improvement over time, elevated anxiety levels are still detectable at 24 months after surgery in approximately 10% of cervical cancer patients. Much more attention should be focused on surgical/medical approaches able to minimize the negative impact of lymphedema and menopausal symptoms on QoL.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Vistad, I" uniqKey="Vistad I">I Vistad</name></author><author><name sortKey="Fossa, Sd" uniqKey="Fossa S">SD Fossa</name></author><author><name sortKey="Dahl, Aa" uniqKey="Dahl A">AA Dahl</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chase, Dm" uniqKey="Chase D">DM Chase</name></author><author><name sortKey="Watanabe, T" uniqKey="Watanabe T">T Watanabe</name></author><author><name sortKey="Monk, Bj" uniqKey="Monk B">BJ Monk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Juraskova, I" uniqKey="Juraskova I">I Juraskova</name></author><author><name sortKey="Butow, P" uniqKey="Butow P">P Butow</name></author><author><name sortKey="Robertson, R" 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<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Cancer</journal-id><journal-id journal-id-type="iso-abbrev">BMC Cancer</journal-id><journal-title-group><journal-title>BMC Cancer</journal-title></journal-title-group><issn pub-type="epub">1471-2407</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23506235</article-id><article-id pub-id-type="pmc">3608958</article-id><article-id pub-id-type="publisher-id">1471-2407-13-127</article-id><article-id pub-id-type="doi">10.1186/1471-2407-13-127</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis</article-title></title-group><contrib-group><contrib contrib-type="author" id="A1"><name><surname>Mantegna</surname><given-names>Giovanna</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>giovanna.mantegna@rm.unicatt.it</email></contrib><contrib contrib-type="author" id="A2"><name><surname>Petrillo</surname><given-names>Marco</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>afpetrillo@libero.it</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Fuoco</surname><given-names>Gilda</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>gildafuoco@gmail.com</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Venditti</surname><given-names>Laura</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>laura.venditti@gmail.com</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Terzano</surname><given-names>Serena</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>serena.terzano@gmail.com</email></contrib><contrib contrib-type="author" id="A6"><name><surname>Anchora</surname><given-names>Luigi Pedone</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>luigi.us@hotmail.it</email></contrib><contrib contrib-type="author" id="A7"><name><surname>Scambia</surname><given-names>Giovanni</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>giovanni.scambia@rm.unicatt.it</email></contrib><contrib contrib-type="author" corresp="yes" id="A8"><name><surname>Ferrandina</surname><given-names>Gabriella</given-names></name><xref ref-type="aff" rid="I2">2</xref><email>gabriella.ferrandina@libero.it</email></contrib></contrib-group><aff id="I1"><label>1</label>Psycho-Oncology Service, Catholic University, Campobasso, Italy</aff><aff id="I2"><label>2</label>Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Catholic University Rome, Rome, Italy</aff><aff id="I3"><label>3</label>Gynecologic Oncology Unit, Department of Oncology, Catholic University, Campobasso, Italy</aff><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>18</day><month>3</month><year>2013</year></pub-date><volume>13</volume><fpage>127</fpage><lpage>127</lpage><history><date date-type="received"><day>5</day><month>10</month><year>2012</year></date><date date-type="accepted"><day>10</day><month>3</month><year>2013</year></date></history><permissions><copyright-statement>Copyright ©2013 Mantegna et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Mantegna et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><self-uri xlink:href="http://www.biomedcentral.com/1471-2407/13/127"></self-uri><abstract><sec><title>Background</title><p>A long-term prospective assessment of QoL in cervical cancer patients is still lacking. Here, we provide the first 2-years prospective, longitudinal study evaluating emotional distress and QoL in early stage (ECC) and locally advanced (LACC) cervical cancer patients who remained disease-free 2-years from diagnosis.</p></sec><sec><title>Methods</title><p>The questionnaires: Hospital Anxiety and Depression Scale (HADS), Global Health Status items of EORTC QLQ-C30 (GHS), and EORTC QLQ-CX24 (CX24) have been administered by a dedicated team of psycho-oncologists, administered at baseline, and after 3, 6, 12 and 24 months from surgery The Generalized Linear Model for repeated measure was used to analyze modifications of QoL measures over time.</p></sec><sec><title>Results</title><p>In both groups, an early reduction of the percentage of patients with anxiety levels ≥11 was observed at the 3-month evaluation (ECC: 25.7% at baseline Vs 14.7% after 3 months, p value=0.001; LACC: 22.2% at baseline Vs 15.4% after 3 months, p value=0.001). Despite this favorable trend, after 2 years from diagnosis, 11.9% of ECC and 15.6% of LACC patients still showed an anxiety score ≥11. No significant changes over time were observed in term of Depression levels. Focusing on QoL issues, mean GHS and Sexual Activity scores showed an improvement over time in both groups compared to baseline (GHS: 5.7% difference for ECC, p value=0.001, and 11.0% in LACC, p value=0.001; SXA: 13.9% difference for ECC, p value=0.001; and 6.1% in LACC, p value=0.008). On the other hand, Body Image mean scores were significantly impaired by chemoradiation administration in LACC patients, without long-term recovery (7.5% difference, p value=0.001). Finally, in both groups, lymphedema (LY) and menopausal symptoms (MS) showed an early worsening which persisted 2-year after surgery (LY: 19.5% difference for ECC, p value=0.014, and 27.3% in LACC, p value=0.001; MS: 14.4% difference for ECC, p value=0.004, and 16.0% in LACC, p value=0.002).</p></sec><sec><title>Conclusions</title><p>Despite a significant improvement over time, elevated anxiety levels are still detectable at 24 months after surgery in approximately 10% of cervical cancer patients. Much more attention should be focused on surgical/medical approaches able to minimize the negative impact of lymphedema and menopausal symptoms on QoL.</p></sec></abstract><kwd-group><kwd>Quality of life</kwd><kwd>Emotional distress</kwd><kwd>Cervical cancer</kwd><kwd>Prospective study</kwd><kwd>Long-term evaluation</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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