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Long-term quality of life outcomes of women treated for early-stage endometrial cancer
  1. Saira Sanjida1,
  2. Andreas Obermair2,
  3. Val Gebski3,
  4. Nigel Armfield2 and
  5. Monika Janda1
  1. 1 Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  3. 3 NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Monika Janda, Centre for Health Services Research, The University of Queensland, Brisbane, QLD 4102, Australia; m.janda{at}


Objective To compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.

Methods Once the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.

Results Of 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.

Conclusion Compared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.

  • endometrial neoplasms
  • hysterectomy

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  • Contributors SS contributed to data analysis, writing original draft. AO contributed to conceptualization, methodology, and critical revision of manuscript. VG critically revised the manuscript. NA contributed to data analysis of manuscript. MJ contributed to conceptualization, methodology, critical revision, writing review, and editing of manuscript. All authors approved the final draft of the manuscript.

  • Funding MJ was funded by NHMRC Translating Research into Practice fellowship APP1151021. This project was funded by Cancer Australia Priority-driven Collaborative Cancer Research Scheme (reference 1098905).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The work was approved by the following ethics committees: Royal Brisbane and Women’s Hospital Health Service (2004/25); Mater Health Services (777P); Greenslopes Private Hospital (04/12); The University of Queensland (2006000368); Uniting Health Care (2004/60); Royal Adelaide Hospital (070413); Christchurch Women’s Hospital (URB/06/06/0649); Hunter New England Health (07/03/21/3.04); Sydney West Area Heath Service (HREC2006/12/4.27(2292); Southern Health (04144C); Royal Women’s Hospital (06/30); Princess Margaret Hospital (1154/EW).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. In accordance with the journal’s guidelines, we will provide our data for the reproducibility of this study in other centers, if requested.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.