Long-term fatigue and quality of life among epithelial ovarian cancer survivors: a GINECO case/control VIVROVAIRE I study

Abstract

Background: Few data are available on long-term fatigue (LTF) and quality of life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free !3 years after first-line treatment and age-matched healthy women. Patients and methods: EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regressions were conducted to analyze SLTF and its influencing factors in EOCS. Results: A total of 318 EOCS and 318 controls were included. EOCS were 63-year-old on average, with FIGO stage I/II (50%), III/IV (48%); 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 versus 45, P < 0.0001), lower functional well-being scores (18 versus 20, P ¼ 0.0002), poorer FACT-O scores (31 versus 34 P < 0.0001), and poorer FACT-Ntx scores (35 versus 39, P < 0.0001). They also reported more SLTF (26% versus 13%, P ¼ 0.0004), poorer sleep quality (63% versus 47%, P ¼ 0.0003), and more depression (22% versus 13%, P ¼ 0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (P < 0.01). Conclusion: Compared with controls, EOCS presented similar QoL but persistent LTF, EOC-related symptoms, neurotoxicity, depression, and sleep disturbance. Depression, neuropathy, and sleep disturbance are the main conditions associated with severe LTF.

Mechanistic insights into the pathogenesis of microtubule‐targeting agent‐induced peripheral neuropathy from pharmacogenetic and functional studies

“…Furthermore, CIPN symptoms can present acutely, persist for years or even progress post‐therapy 3,14 . In severe cases, sensorimotor deficits may be irreversible 15 . Severe CIPN symptoms can interfere with activities of daily living such as writing, dressing and walking, significantly limiting quality of life 16 .…”

Patterns and predictors of cancer‐related fatigue in ovarian and endometrial cancers: 1‐year longitudinal study

“…Despite significant advances in the treatment of gynecologic cancers, 1 patients with endometrial and ovarian cancers experience late effects from treatment 2 . Cancer‐related fatigue (CRF) is one of the most common and distressing symptoms reported 3 .…”

“…To date, researchers have examined CRF in patients with early‐stage disease and common cancers 3,8 . A recent cross‐sectional study demonstrated that 20% of long‐term, relapse‐free survivors of ovarian cancer reported persistent CRF, and it was associated with high levels of depression, peripheral neuropathy, and sleep disturbance 2 . However, few researchers have examined CRF in patients with early‐ and late‐stage gynecologic cancers longitudinally.…”

Patient-Reported Outcomes (PROs) and Health-Related Quality of Life (HR-QoL) in Patients with Ovarian Cancer: What Is Different Compared to Healthy Women?

“…In our present analysis, the younger patients with ovarian cancer were more affected by fatigue and sleep disturbance. The global QoL of women with ovarian cancer neutralizes after treatment to levels like those found in the normal population, but chronic fatigue, ovarian cancer-related symptoms, neurotoxicity, depression, and sleep disturbances persist as long-term side effects in cancer survivors [30].…”