Article Text
PDF
Abstract
Introduction/Background Pelvic exenteration (PE) can result in considerable acute and long-term morbidity. Routine longitudinal assessment of quality of life (QoL) of women with recurrent/persistent gynaecological cancer undergoing/had undergone PE, was implemented in 2012 to evaluate trends in QoL prospectively.
Methodology The European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) was completed by women before and/or after PE attending out-patient consultations between 2012 and 2018. Data were collected at various time-points from baseline to up to12 years post-surgery. Descriptive analysis, frequencies and independent chi-square tests were performed.
Results Forty-two women underwent PE with curative intent, with a mean age of 58 years (SD 10.8) were included, 40 had received pelvic radiotherapy, and 60% had cervical or endometrial cancer. A total PE was performed in 52% (n=22) of women, anterior PE in 28% (N=12) and posterior PE in 20% (n=8). In 31% of total PE cases a double-barrelled stoma was formed.
Global health status
Functional scores
QoL at baseline was poor, further decreased at 1-month post-surgery, showed a steady improvement after 6 months, which continued long-term (>5 years) both in Global Health status and all functioning scores. With the exception of diarrhoea and insomnia, all symptoms significantly improved 1-month post-surgery. Pain scores halved from baseline to 1–2 years (43.5 to 20). In women with a total PE, those with a double-barrelled stoma had better emotional, social and cognitive functioning compared to those who had a colostomy and urostomy(e.g. x2(8, 68) =17.58 p<0.05).
Conclusion PE can improve the QoL of women with recurrent/persistent gynaecological cancer who are symptomatic. In cases of total PE, the double-barrelled stoma have better outcomes compared to two stomas. These findings will better inform women for whom PE is offered as a treatment option. They highlight the importance of continued interdisciplinary collaboration from the planning of surgery to long-term follow-up.
Disclosure Nothing to disclose.