Supportive Care in Cancer

, Volume 18, Issue 8, pp 931–942 | Cite as

Development of the Berlin Symptom Checklist Ovary (BSCL-O) for the measurement of quality of life of patients with primary and recurrent ovarian cancer: results of a phase I and II study

  • Dominique Koensgen
  • Guelten Oskay-Oezcelik
  • Ioanna Katsares
  • Ulla Walle
  • Christine Klapp
  • Alexander Mustea
  • Dirk Stengel
  • Franz Porzsolt
  • Werner Lichtenegger
  • Jalid Sehouli
  • on behalf of the Nord-Ostdeutschen Gesellschaft für Gynäkologische Onkologie (NOGGO) working group “Quality of life”
Original Article


Goals of work

Quality of life (Qol) represents a relevant end point in the clinical management of advanced ovarian cancer (AOC). However, there exist only a few specific instruments which have been designed for patients with ovarian cancer. The aim of this study was to develop a systematic checklist (Berlin Symptom Checklist Ovary (BSCL-O)) as an instrument of Qol for patients with AOC and to discriminate between the frequency and the importance of symptoms.

Patients and methods

The main symptoms were identified in a phase I study via free interviews of five patients with ovarian cancer (OC) as well as five medical doctors, family dependants, and care workers. In the phase II study, the capability of BSCL-O was evaluated by questionnaire-guided interviews of 200 patients with primary OC, recurrent OC, metastasized breast cancer, and benign ovarian tumors.

Main results

In phase I, 36 main symptoms were identified. In phase II, 7,200 answers from 98.5% of all patients were evaluable. Of the 36 symptoms of the BSCL-O, 23 revealed clinical relevance. There was a correlation of frequency and importance of symptoms (p < 0.05). The symptoms of the BSCL-O were deemed twice as strenuous in patients with recurrent OC.


The BSCL-O can measure Qol of patients with OC. The BSCL-O is being validated in a phase III study.


Quality of life Instruments of measurement Ovarian cancer 



We wish to thank the patients, their family dependants, the medical doctors, and the care workers who participated in this trial. Without their enthusiastic collaboration, this work would not have been possible.


  1. 1.
    Anderson B (1994) Quality of life in progressive ovarian cancer. Gynecol Oncol 55:151–155Google Scholar
  2. 2.
    Basen-Engquist K, Bodurka-Bevers D, Fitzgerald MA et al (2001) Reliability and validity of the functional assessment of cancer therapy-ovarian. J Clin Oncol 19(6):1809–1817PubMedGoogle Scholar
  3. 3.
    Bullinger M (1996) Methoden zur Lebensqualitätsbewertung in der Onkologie. Forum Deutsche Krebsgesellschaft 11:210–216Google Scholar
  4. 4.
    Calhoun EA, Welshman EE, Chang CH et al (2003) Psychometric evaluation of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire for patients receiving systemic chemotherapy. Int J Gynecol Cancer 13(6):741–748CrossRefPubMedGoogle Scholar
  5. 5.
    Cella DF, Tulsky DS, Gray G et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579PubMedGoogle Scholar
  6. 6.
    Coates A, Dillenbeck CF, McNeil DR et al (1983) On the receiving end-II. Linear analogue self-assessment (LASA) in evaluation of aspects of the quality of life of cancer patients receiving therapy. Eur J Cancer Clin Oncol 19:1633–1637CrossRefPubMedGoogle Scholar
  7. 7.
    Cull A, Howat S, Greimel E et al (2001) Development of a European organization for research and treatment of cancer questionnaire module to assess the quality of life of ovarian cancer patients in clinical trials: a progress report. Eur J Cancer 37:47–53CrossRefPubMedGoogle Scholar
  8. 8.
    Ersek M, Ferrell B, Dow K et al (1997) Quality of life in women with ovarian cancer. West J Nurs Res 19:334–350CrossRefPubMedGoogle Scholar
  9. 9.
    Fish L, Lewis B (1999) Quality of life issues in the management of ovarian cancer. Semin Oncol 26:32–39PubMedGoogle Scholar
  10. 10.
    Greimel ER, Bjelic-Radisic V, Pfisterer J et al (2006) Randomized study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group comparing quality of life in patients with ovarian cancer treated with cisplatin/paclitaxel versus carboplatin/paclitaxel. J Clin Oncol 24(4):579–586CrossRefPubMedGoogle Scholar
  11. 11.
    Greimel E, Bottomley A, Cull A et al (2003) An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-OV28) in assessing the quality of life of patients with ovarian cancer. Eur J Cancer 39:1402–1408CrossRefPubMedGoogle Scholar
  12. 12.
    Guidozzi F (1993) Living with ovarian cancer. Gynecol Oncol 50:202–207CrossRefPubMedGoogle Scholar
  13. 13.
    Jacobs I, van Nagell J, DePriest P Jr (1998) Screening for epithelial ovarian cancer. In: David M, Gershenson W, Mcguire P (eds) Ovarian cancer: controversies in management. Medical Division of Pearson Professional Limited, New York, pp 1–15Google Scholar
  14. 14.
    Le T, Leis A, Pahwa P et al (2004) Quality of life evaluations of caregivers of ovarian cancer patients during chemotherapy treatment. J Obstet Gynaecol Can 26(7):627–631PubMedGoogle Scholar
  15. 15.
    Montazeri A, McEwen J, Gillis C (1996) Quality of life in patients with ovarian cancer: current state of research. Support Care Cancer 4:169–179CrossRefPubMedGoogle Scholar
  16. 16.
    Moore DH (1994) Ovarian cancer in the elderly patient. Oncology (Williston Park) 8:21–30Google Scholar
  17. 17.
    Oskay-Ozcelik G, Sehouli J (2009) Pros and cons for systemic therapy in recurrent ovarian cancer. Anticancer Res 29(7):2831–2836PubMedGoogle Scholar
  18. 18.
    Portenoy R, Kornblith A, Wong G (1994) Pain in ovarian cancer patients. Cancer 74:907–915CrossRefPubMedGoogle Scholar
  19. 19.
    Portenoy R, Thaler H, Kornblith A (1994) The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A:1326–1336CrossRefPubMedGoogle Scholar
  20. 20.
    Sun CC, Bodurka DC, Weaver CB et al (2005) Rankings and symptom assessments of side effects from chemotherapy: insights from experienced patients with ovarian cancer. Support Care Cancer 13:219–227CrossRefPubMedGoogle Scholar
  21. 21.
    Wenzel L, Huang HQ, Monk BJ et al (2005) Quality-of-life comparisons in a randomized trial of interval secondary cytoreduction in advanced ovarian carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 23(24):5605–5612CrossRefPubMedGoogle Scholar
  22. 22.
    Willemse P, van Lith J, Mulder N (1990) Risk and benefits of cisplatin in ovarian cancer. A quality-adjusted survival analysis. Eur J Cancer 26:345–352CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Dominique Koensgen
    • 1
  • Guelten Oskay-Oezcelik
    • 3
  • Ioanna Katsares
    • 2
  • Ulla Walle
    • 3
  • Christine Klapp
    • 3
  • Alexander Mustea
    • 1
  • Dirk Stengel
    • 4
  • Franz Porzsolt
    • 5
  • Werner Lichtenegger
    • 3
  • Jalid Sehouli
    • 3
  • on behalf of the Nord-Ostdeutschen Gesellschaft für Gynäkologische Onkologie (NOGGO) working group “Quality of life”
  1. 1.Clinic of Gynecology and ObstetricsErnst-Moritz-Arndt University Hospital GreifswaldGreifswaldGermany
  2. 2.Clinic of Gynecology and ObstetricsKlinikum Bremen-MitteBremenGermany
  3. 3.Department of Obstetrics and Gynecology, Campus Virchow ClinicCharité University HospitalBerlinGermany
  4. 4.Institute of Clinical Epidemiology, Clinic for SurgeryUnfallkrankenhaus BerlinBerlinGermany
  5. 5.Institute for Clinical EconomicsUniversity of UlmUlmGermany

Personalised recommendations