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Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches
  1. Anne Lanceley, PhD,
  2. Carlo Berzuini, PhD,
  3. Matthew Burnell, PhD,
  4. Sue Gessler, PhD,
  5. Stephen Morris, PhD,
  6. Andy Ryan, PhD,
  7. Jonathan A. Ledermann, MD and
  8. Ian Jacobs, MBBS
  1. * Department of Women’s Cancer, The UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London;
  2. Centre for Biostatistics, The University of Manchester, Manchester;
  3. University College London Hospitals (UCLH) Gynaecological Cancer Centre;
  4. § Department of Applied Health Research, University College London;
  5. Cancer Research UK and UCL Cancer Trials Centre, University College London, London, United Kingdom; and
  6. University of New South Wales, Sydney, New South Wales, Australia.
  1. Address correspondence and reprint requests to Anne Lanceley, PhD, Department of Women’s Cancer, The UCL Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 74 Huntley St, London WC1E 6AU. E-mail: a.lanceley{at}ucl.ac.uk.

Abstract

Objective The aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer.

Methods One hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group.

Results There was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, −0.03 to −0.001; PSQ-III P = 0.002; 95% confidence interval, −0.003 to −0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07).

Conclusions Individualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.

Trial registration number is ISRCTN59149551.

  • Ovarian cancer
  • Follow-up
  • Nurse-led

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Footnotes

  • The authors declare no conflicts of interest.

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