Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

Miguel, Taís Pereira; Laurienzo, Carla Elaine; Faria, Eliney Ferreira; Sarri, Almir José; Castro, Isabela Queiroz; Júnior, Renato José Affonso; Andrade, Carlos Eduardo Mattos da Cunha; Vieira, Marcelo de Andrade; Reis, Ricardo dos

doi:10.1371/journal.pone.0234389

Cited by 15 publications

(6 citation statements)

References 26 publications

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“…We also observed a high burden of urinary incontinence in patients with cervical cancer. Chemoradiation poses additional risks of weakening the pelvic floor muscle causing issues such as urinary incontinence 26 . Anticholinergics can be prescribed to treat bladder control issues which may improve the psychological wellbeing of survivors and overall quality of life; however, care must be taken to identify potential contraindications to anticholinergics.…”

Section: Discussionmentioning

confidence: 99%

Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

2023

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A comprehensive evaluation of the total burden of morbidity endured by cancer survivors remains unavailable. This study quantified the burden of 144 health conditions and critical care admissions across 26 adult cancers and treatment modalities in 243,767 adults. By age 60, top conditions ranked by fold difference (cumulative burden in survivors divided by cumulative burden in controls) were haematology, immunology/infection and pulmonary conditions. Patients who had all three forms of treatment (chemotherapy, radiotherapy and surgery) experienced a high cumulative burden of late morbidities compared with patients who received radiotherapy alone. The top five cancers with the highest cumulative burden of critical care admissions by age 60 were bone (12.4 events per 100 individuals [CI: 11.6-13.1]), brain (9.0 [7.5-10.5]), spinal cord and nervous system (7.2 [6.7-7.8]), testis (6.7 [4.9-8.4]) and Hodgkin lymphoma (4.4 [3.6-5.1]). Conditions that were associated with high excess years-of-life-lost were haematological conditions (9.6 years), pulmonary conditions (8.6 years) and immunological conditions or infections (7.8 years). As the population of cancer survivors continues to grow, our results indicate that it is important to tackle long-term health consequences through enacting data-driven policies.

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Section: Discussionmentioning

confidence: 99%

Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

2023

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“…Pelvic floor dysfunction is a common complication after cervical cancer surgery, with an incidence of up to 50% ( 2 , 5 ). The results herein demonstrated that age greater than 65 years, open surgery, total hysterectomy, and radiotherapy were risk factors of postoperative pelvic floor dysfunction in patients with cervical cancer (P<0.05).…”

Section: Discussionmentioning

confidence: 99%

Identifying the risk factors and developing a predictive model for postoperative pelvic floor dysfunction in cervical cancer patients

Liu¹,

Zhu²,

Li³

et al. 2023

Transl Cancer Res

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Background: Pelvic floor dysfunction is a common complication after cervical cancer surgery, and the key to early prevention and treatment is the timely identification of risk factors and high-risk patients. The present study explored the risk factors of pelvic floor dysfunction in cervical cancer patients after surgery and established a predictive model.Methods: A total of 282 cervical cancer patients admitted to Wuhan No.7 Hospital from January 2020 to June 2022 was retrospectively enrolled in this study. All patients underwent surgery and were followed up after surgery. The patients were divided into a pelvic floor dysfunction group (n=92) and a control group (n=190) according to whether they developed pelvic floor dysfunction or not at 6 months post-surgery. The differences in clinical features between the two groups were observed to identify the risk factors of pelvic floor dysfunction after cervical cancer, and a prediction model was established.Results: There were significant differences in age, surgical method, surgical resection range, and radiotherapy between the two groups (P<0.05). Age greater than 65 years, open surgery, total hysterectomy, and radiotherapy were identified as the risk factors of postoperative pelvic floor dysfunction in patients with cervical cancer (P<0.05). The R4.0.3 statistical software was used to randomly divide the dataset into a training dataset (n=141) and a validation dataset (n=141). The area under the curve was 0.755 (95% confidence interval: 0.673-0.837) in the training set and 0.604 (95% confidence interval: 0.502-0.705) in the verification set. In the validation set, the model was tested with a Hosmer-Lemeshow Goodness-of-Fit test, with a chi-square value of 9.017 and a P value of 0.341. Conclusions: Patients with cervical cancer have a high incidence of postoperative pelvic floor dysfunction. Age greater than 65 years, open surgery, total hysterectomy, and radiotherapy are risk factors of postoperative pelvic floor dysfunction in cervical cancer patients, and the present model helps to identify patients at highrisk of pelvic floor dysfunction.

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“…However, acute toxicity and diarrhea during radiation therapy for CC significantly increase the risk of severe late toxicity and affect the patient's QoL. Radiotherapy is known to cause fibrosis in bladder walls, which results in a low compliance of the bladder and explains the elevated risk of urinary urgency and frequency in patients who undergo primary radiotherapy [20,21]. Therefore, oncologists should consider a treatment strategy to minimize the development of PFD following adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

Wang

Wen

Gao

et al. 2021

Gynecol Obstet Invest

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Objectives: Our study aimed to evaluate the quality of life (QoL) and pelvic floor function of cervical cancer (CC) patients after treatment. Design: This was a cross-sectional observational cohort study. Participants: The participants included in this study were CC patients who underwent radical hysterectomy (RH) from 2012 to 2018 at 18 medical centers across China. Methods: The validated versions of the Pelvic floor Distress Inventory-Short Form 20, Overactive Bladder Symptom Score, and Euro Qol Five-Dimension questionnaires were used to evaluate postoperative pelvic floor dysfunction (PFD) and QoL. Results: A total of 689 CC patients were enrolled. The incidence of stress urinary incontinence (SUI), incomplete urinary emptying, and constipation were 32.7, 27.7, and 28.6%, respectively. Multivariate analysis confirmed that laparoscopic RH (LRH) and vaginal wall resection greater than 3 cm were risk factors for lower urinary tract symptoms (LUTS). LRH and chemotherapy were risk factors for SUI. Chemoradiotherapy and LRH were risk factors for overactive bladder (OAB). A high body mass index and LRH were risk factors for more severe defecation symptoms. ARH and large amount of operative blood loss were risk factors for poor QoL. Conclusion: PFD is common in CC patients after treatment. LRH seems to increase the postoperative distress, including LUTS and defecation symptoms. Postoperative urinary incontinence and OAB are more bothersome for patients undergoing chemotherapy and radiotherapy. We recommend evaluating pelvic floor function as a standard assessment during follow-up.

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Chemoradiation for cervical cancer treatment portends high risk of pelvic floor dysfunction

Cited by 15 publications

References 26 publications

Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

Cumulative burden of 144 conditions, critical care hospitalisation and premature mortality across 26 adult cancers

Identifying the risk factors and developing a predictive model for postoperative pelvic floor dysfunction in cervical cancer patients

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

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