1. Prospective Assessment of First-Year Quality of Life After Pelvic Exenteration for Gynecologic Malignancy: A French Multicentric Study
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G. Ferron, P. Morice, Frédéric Marchal, I. Jaffré, Michel Rivoire, Eric Lambaudie, G. Houvenaeghel, Denis Querleu, Eberhard Stoeckle, F. Foucher, Pierre Meeus, Sebastien Gouy, Thomas Filleron, J-M Classe, Pierre-Emmanuel Colombo, N. Chopin, Vincent Lavoué, Fabrice Narducci, Jean Levêque, Eva Jouve, Philippe Rouanet, Frédéric Guyon, Alejandra Martinez, J. L. Verheaghe, Eric Leblanc, A. Mourregot, Institut Claudius Regaud, Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CRLCC Val d'Aurelle - Paul Lamarque, Centre Léon Bérard [Lyon], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, CHU Pontchaillou [Rennes], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Département de chirurgie gynécologique [Gustave Roussy], Institut Gustave Roussy (IGR), Institut Bergonié [Bordeaux], Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Lille Nord de France (COMUE)-UNICANCER, CRLCC Institut Claudius Regaud, Institut de cancérologie de l'Ouest - Nantes (ICO Nantes), CRLCC Paul Papin-CRLCC René Gauducheau, CRLCC Oscar Lambret, Institut Bergonié - CRLCC Bordeaux, and Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL)
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medicine.medical_treatment ,0302 clinical medicine ,MESH: Pelvic Exenteration ,MESH: Genital Neoplasms, Female ,Quality of life ,Surgical oncology ,MESH: Postoperative Period ,Surveys and Questionnaires ,Medicine ,Postoperative Period ,Prospective Studies ,Prospective cohort study ,MESH: Aged ,030219 obstetrics & reproductive medicine ,MESH: Middle Aged ,MESH: Follow-Up Studies ,Middle Aged ,Prognosis ,humanities ,3. Good health ,Oncology ,030220 oncology & carcinogenesis ,Female ,medicine.symptom ,Psychosocial ,Adult ,medicine.medical_specialty ,Genital Neoplasms, Female ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Anorexia ,MESH: Prognosis ,03 medical and health sciences ,Body Image ,Humans ,MESH: Surveys and Questionnaires ,MESH: Body Image ,Aged ,MESH: Humans ,Pelvic exenteration ,business.industry ,General surgery ,MESH: Quality of Life ,MESH: Adult ,MESH: Prospective Studies ,Pelvic Exenteration ,Surgery ,Gynecologic malignancy ,Quality of Life ,Sexual function ,business ,MESH: Female ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Follow-Up Studies - Abstract
International audience; BACKGROUND:Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent.METHODS:A French multicentric prospective study was performed by including patients who underwent pelvic exenteration. Quality of life by measurement of functional and symptom scales was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 questionnaires before surgery, at baseline, and 1, 3, 6, and 12 months after the procedure.RESULTS:The study enrolled 97 patients. Quality of life including physical, personal, fatigue, and anorexia reported in the QLQ-C30 was significantly reduced 1 month postoperatively and improved at least to baseline level 1 year after the procedure. Body image also was significantly reduced 1 month postoperatively. Global health, emotional, dyspnea, and anorexia items were significantly improved 1 year after surgery compared with baseline values. Unlike younger patients, elderly patients did not regain physical and social activities after pelvic exenteration.CONCLUSIONS:Therapeutic decision on performing a pelvic exenteration can have a severe and permanent impact on all aspects of patients' QOL. Deterioration of QOL was most significant during the first 3 months after surgery. Elderly patients were the only group of patients with permanent decreased physical and social function. Preoperative evaluation and postoperative follow-up evaluation should include health-related QOL instruments, counseling by a multidisciplinary team to cover all aspects concerning stoma care, sexual function, and long-term concerns after surgery.
- Published
- 2018
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