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Perceived Health-Related Quality of Life in Women With Vulvar Neoplasia: A Cross Sectional Study
  1. Andrea Kobleder, Mag, RN*,
  2. Nataša Nikolic, MSc, RN,
  3. Mareike Hechinger, BScN, RN,
  4. Kris Denhaerynck, PhD§,
  5. Monika Hampl, PhD, MD,
  6. Michael D. Mueller, PhD, MD and
  7. Beate Senn, PhD, RN#,**
  1. *Institute for Applied Nursing Sciences IPW, University of Applied Sciences FHS St. Gallen, St. Gallen;
  2. Departement of Neurosurgery, University Hospital Zurich, Zürich, Switzerland;
  3. Hechinger Nursing GmbH, Munich, Germany;
  4. §Institute of Nursing Science, University of Basel, Basel, Switzerland;
  5. Department of Obstetrics and Gynaecology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany;
  6. Department of Gynecology and Obstetrics, Bern University Hospital, Bern, Switzerland;
  7. #Institute for Nursing Science IPW, University of Applied Sciences FHS St. Gallen, St. Gallen, Switzerland; and
  8. **Sydney Nursing School, University of Sydney, Sydney, Australia.
  1. Address correspondence and reprint requests to Andrea Kobleder, Mag, Institute for Applied Nursing Sciences IPW, University of Applied Sciences FHS St. Gallen, Switzerland. Rosenbergstrasse 59, CH-9001 St. Gallen. E-mail:


Objective The aim of the study was to determine health-related quality of life (HRQoL) of women with surgically treated vulvar intraepithelial neoplasia (VIN) and vulvar cancer (VC) during the first week after hospital discharge. Further objectives were to investigate differences between women with VIN and VC as well as to examine whether correlations exist between women’s symptom experience and HRQoL.

Methods This cross-sectional study was conducted in 8 hospitals in Germany and Switzerland. Women with VIN and VC rated HRQoL with the validated German Short-Form 36. Differences between HRQoL in women with VIN and VC were tested with Wilcoxon rank-sum score. The WOMen with vulvAr Neoplasia (WOMAN) - Patient reported Outcome (PRO) self-report instrument was used to measure women’s symptom experience. Correlations between symptoms and HRQoL were calculated using Spearman correlation coefficient.

Results Women with VIN and VC (n = 65) reported lower HRQoL in physical aspects (Physical Component Summary [PCS], 34.9) than that in mental aspects (Mental Component Summary, 40.5). Women with VC had lower HRQoL than women with VIN, as manifested by significant differences concerning the dimensions of “physical functioning” and “role-physical.” “Difficulties in daily life” as a distressing symptom correlated with MCS and PCS. Wound-related symptoms correlated with PCS and psychosocial symptoms/issues with MCS.

Conclusions Analysis showed that women with vulvar neoplasia reported lower HRQoL in the physical and mental dimensions 1 week after discharge than comparable studies referring to months or years after surgery. Health-related quality of life is influenced by physical impairment because physical symptoms are prevalent 1 week after discharge. Patient education should focus on symptom management in an early postsurgical phase to enhance women’s HRQoL.

  • Quality of life
  • Patient-reported outcome
  • Vulvar cancer
  • Vulvar intraepithelial neoplasia

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  • Financial support: Foundation Cancer Research Switzerland, KFS 02456-08-2009.

  • The authors declare no conflicts of interest.