Multi-dimensional measurements of long-term quality of life and recovery patterns of patients with cervical cancer after treatment.
Authors: Ling Qiu, Shurong Zhu, Hui Wang, Hao Feng, Shen Luo, Xiaoyi Yang, Yingchun Hou, Tao Zhang, Junda Zhao, Danze Qiao, Yan Du, Hua Jiang, Xin Wu
Journal: Journal of Clinical Oncology (2024)

e17533 Background: Cervical cancer is a prevalent malignancy affecting the female reproductive system globally, and its incidence among younger individuals is on the rise. This study employed the CC-PRO137 scale to evaluate the long-term quality of life and recovery patterns of cervical cancer patients post- treatment. Clinicians are guided to provide individualized treatment and psychological support. Methods: This study recruited patients with primary cervical cancer who underwent primary surgical treatment at the Obstetrics and Gynecology Hospital of Fudan University from October 2018 to June 2021. The CC-PRO137 (Cervical Cancer Patient Reported Clinical Outcome Assessment Scale) was used for follow-up to assess changes in the patients' physical, psychological, and social life states. The data was analyzed to examine variations in the recovery status of the patients across 13 modules: urinary function (URI), bowel function (BOW), pelvic organ prolapse (POP), ovarian function (OVA), lymphatic function (LYM), nervous function (NEU), sexual function (SEX), anxiety (ANX), depression (DEP), shame (SHA), belief (BEL), social support (SUP), and daily life (LIF). Subgroup analysis was conducted based on different stages, surgical methods, and adjuvant treatment plans. Results: A total of 304 participants were tested both 6 months and 12 months after the completion of treatment. The scores for URI, NEU, and SEX were significantly higher after one year compared to within 6 months (URI: t=-3.519, p=0.001; NEU: t=-2.138, p=0.033; SEX: t=-2.338, p=0.021). This suggests a notable improvement in urinary function, nervous function, and sexual function after 12 months. In terms of the psychological domain, DEP scores were significantly higher after 12 months compared to within 6 months ( t=-2.517, p=0.012). The LIF index showed a significant improvement after 12 months ( t=-5.224, p&lt;0.001). Subgroup analysis revealed that Stage II had worse outcomes compared to Stages I and III, particularly in terms of URI ( F(2,297) = 10.619, p &lt; 0.001) and POP ( F(2,299) = 8.559, p&lt; 0.001) indexes. The laparoscopy had a greater impact on the urinary system ( t = 2.157, p = 0.046). The adverse effects of concurrent chemoradiotherapy on URI ( F(2,297) = 11.497, p &lt; 0.001) and DEP ( F(2,299) = 4.149, p = 0.017) functions were more significant than those of chemotherapy. Conclusions: The recovery of patients following cervical cancer treatment is primarily observed in improvements in urinary, bowel, and nervous functions in the physiological domain. In the psychological domain, there is a noticeable improvement in depressive state, while the social life domain also shows signs of improvement over time. By focusing on the disease impact within a limited time frame, the scale helps clinicians provide targeted guidance and advice based on the main issues.