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Prospective Assessment of First-Year Quality of Life After Pelvic Exenteration for Gynecologic Malignancy: A French Multicentric Study

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

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.

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Acknowledgments

We thank Chantal Franco and Vincent Mauries for their valuable help in data management. This study was financially supported by the STIC (support for innovative and expensive techniques) from the Institute National du Cancer (INCA).

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Authors and Affiliations

  1. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse, France

    A. Martinez PhD, MD, E. Jouve MD & G. Ferron PhD, MD

  2. Centre de Recherches en Cancérologie de Toulouse (CRCT), UMR 1037 INSERM, Toulouse, France

    A. Martinez PhD, MD

  3. Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse, France

    T. Filleron PhD, MD

  4. Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France

    P. Rouanet PhD, MD, P. E. Colombo PhD, MD, A. Mourregot MD & N. Chopin MD

  5. Department of Surgical Oncology, CLCC Léon Bérard, Lyon, France

    P. Méeus PhD, MD & M. Rivoire PhD, MD

  6. Department of Surgical Oncology, CLCC Paoli-Calmettes, Marseille, France

    E. Lambaudie PhD, MD & G. Houvenaeghel PhD, MD

  7. Department of Surgical Oncology, CLCC Institut Cancérologique de l’ouest, Nantes, France

    J. M. Classe PhD, MD & I. Jaffre MD

  8. Department of Surgical Oncology, CHU Rennes, Rennes, France

    F. Foucher MD, J. Leveque PhD, MD & V. Lavoue PhD, MD

  9. Department of Surgical Oncology, CLCC Oscar Lambret, Lille, France

    F. Narducci MD & E. Leblanc PhD, MD

  10. Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France

    S. Gouy PhD, MD & P. Morice PhD, MD

  11. Department of Surgical Oncology, Institut Bergonié, Bordeaux, France

    F. Guyon PhD, MD, E. Stoeckle PhD, MD & D. Querleu PhD, MD

  12. Department of Surgical Oncology, Institut Cancérologie de Lorraine, Nancy, France

    F. Marchal PhD, MD & J. L. Verheaghe MD

Authors
  1. A. Martinez PhD, MD
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  2. T. Filleron PhD, MD
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  3. P. Rouanet PhD, MD
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  4. P. Méeus PhD, MD
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  6. J. M. Classe PhD, MD
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  8. F. Narducci MD
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  9. S. Gouy PhD, MD
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  11. F. Marchal PhD, MD
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  12. E. Jouve MD
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  13. P. E. Colombo PhD, MD
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  14. A. Mourregot MD
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  15. M. Rivoire PhD, MD
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  16. N. Chopin MD
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  17. G. Houvenaeghel PhD, MD
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  18. I. Jaffre MD
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  19. J. Leveque PhD, MD
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  20. V. Lavoue PhD, MD
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  21. E. Leblanc PhD, MD
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  22. P. Morice PhD, MD
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  23. E. Stoeckle PhD, MD
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  24. J. L. Verheaghe MD
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  25. D. Querleu PhD, MD
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  26. G. Ferron PhD, MD
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Corresponding author

Correspondence to A. Martinez PhD, MD.

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Martinez, A., Filleron, T., Rouanet, P. et al. Prospective Assessment of First-Year Quality of Life After Pelvic Exenteration for Gynecologic Malignancy: A French Multicentric Study. Ann Surg Oncol 25, 535–541 (2018). https://doi.org/10.1245/s10434-017-6120-z

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  • DOI: https://doi.org/10.1245/s10434-017-6120-z

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