A multi-institutional survey of the quality of life after treatment for uterine cervical cancer: a comparison between radical radiotherapy and surgery in Japan

Abstract

This study aimed to research the post-treatment quality of life (QOL) between radiotherapy (RT)- and operation (OP)-treated early cervical cancer survivors, using separate questionnaires for physicians and patients. We administered an observational questionnaire to patients aged 20–70 years old with Stages IB1–IIB cervical cancer who had undergone RT or OP and without recurrence as outpatients for ≥6 months after treatment. We divided 100 registered patients equally into two treatment groups (n = 50 each). The average age was 53 and 44 years in the RT and OP groups, respectively. The RT group included 34 and 66% Stage I and II patients, respectively, whereas the OP group included 66 and 34% Stage I and II patients, respectively. The OP group included 58% of patients with postoperative RT. Combination chemotherapy was performed in 84 and 48% of patients in the RT and OP groups, respectively. On the physicians’ questionnaire, we observed significant differences in bone marrow suppression (RT) and leg edema (OP). On the patients’ questionnaire, significantly more patients had dysuria and leg edema in the OP group than in the RT group, and severe (Score 4–5) leg edema was significantly higher in the post-operative RT group than in the OP only group. The frequency of sexual intercourse decreased after treatment in both groups. On the patients’ questionnaire, there were no significant differences between the two groups regarding sexual activity. These findings are useful to patients and physicians for shared decision-making in treatment choices. The guidance of everyday life and health information including sexual life after treatment is important.

Management of Early-Stage Cervical Cancer: A Literature Review

“…A unique clinical randomized trial comparing primary surgery with primary radiotherapy in IB-IIA stages was conducted by Landoni et al in 1997, showing that disease free-survival and overall survival for both groups were the same [15]. Nevertheless, surgery is the primary choice rather than radiotherapy because of quality-of-life issues and ovarian failure, the usual consequences of radiotherapy [28][29][30]. Regarding life quality, the data are still controversial but tend to show more complications and morbidity with radiotherapy [29].…”

“…than radiotherapy because of quality-of-life issues and ovarian failure, the usual consequences of radiotherapy [28][29][30]. Regarding life quality, the data are still controversial but tend to show more complications and morbidity with radiotherapy [29].…”

The Clinical Research on the Anticancer Action of Si-Miao Yong-An Decoction

“…The estimated age-related incidence of cervical cancer was 13.1 per 100,000 women globally and varied widely among countries [7]. Lower extremity edema is a common complication after cervical cancer surgery [8]. It is now considered that its cause is the destruction of lymphatic network during lymph node dissection, resulting in lymphatic stenosis and poor lymph and blood reflux at the distal end of the limb [9].…”

The Association of Preoperative PET-CT and Survival in Patients with Resectable Cervical Cancer

“…For most patients with early-stage IB–IIA cervical cancer, curative surgery is suggested rather than primary radiotherapy (RT). Primary RT with or without chemotherapy is recommended for patients who are not candidates for primary surgery due to medical comorbidities, poor functional status, or limited health resources [ 4 , 5 , 6 ]. Compared with surgery, primary RT is more likely associated with higher long-term morbidity [ 4 , 5 , 6 ].…”

“…Primary RT with or without chemotherapy is recommended for patients who are not candidates for primary surgery due to medical comorbidities, poor functional status, or limited health resources [ 4 , 5 , 6 ]. Compared with surgery, primary RT is more likely associated with higher long-term morbidity [ 4 , 5 , 6 ]. Surgery for cervical cancer is a valuable curative-intent treatment strategy [ 7 , 8 ], irrespective the administration of neoadjuvant or adjuvant treatment.…”