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2022-RA-605-ESGO Long term quality of life after chemotherapy among rare ovarian cancer survivors: the national gineco case-control Vivrovaire Rare Tumors study
  1. Florence Joly1,2,3,4,
  2. Isabelle Laure Ray-Coquard5,6,
  3. Anne Floquet4,7,
  4. Sophie Lefèvre-Arbogast1,
  5. Frederic Selle4,8,
  6. Dominique Berton4,9,
  7. Sophie Frank10,
  8. Thibault De La Motte Rouge11,
  9. Elsa Kalbacher4,12,
  10. Magali Provansal13,
  11. Alain Lortholary14,
  12. Hubert Orfeuvre15,
  13. Jerome Alexandre16,
  14. Paule Augereau17,
  15. Cédric Nadeau18,
  16. Jean-Emmanuel Kurtz19,
  17. Jean-Michel Grellard1,
  18. Bénédicte Clarisse1,
  19. Patricia Pautier4,20 and
  20. Francois Gernier1,2
  1. 1Clinical Research Department, Comprehensive cancer center François Baclesse, CAEN, France
  2. 2INSERM, U1086, Caen, France
  3. 3Université de Caen Basse-Normandie, UMR-S1077, Caen, France
  4. 4Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens, Paris, France
  5. 5Centre Léon Bérard, Lyon, France
  6. 6University Claude Bernard, Lyon, France
  7. 7Comprehensive Cancer Centre Institut Bergonié, BORDEAUX, France
  8. 8Groupe Hospitalier Diaconesses Croix Saint-Simon, PARIS, France
  9. 9ICO Centre René Gauducheau, Saint Herblain, France
  10. 10Curie Cancer Center, PARIS, France
  11. 11Centre Eugène-Marquis, Rennes, France
  12. 12CHRU Jean Minjoz, Besançon, France
  13. 13Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
  14. 14Institut of Cancerology Catherine de Sienne-Hôpital Privé du Confluent, Nantes, France
  15. 15Centre Hospitalier Fleyriat, Bourg En Bresse, France
  16. 16Cochin Hospital, AP-HP, PARIS, France
  17. 17Institut de Cancérologie de l’Ouest, Angers, France
  18. 18University Hospital Poitiers, Poitiers, France
  19. 19ICANS, Strasbourg, France
  20. 20Gustave Roussy Cancer Center, PARIS, France


Introduction/Background Treatments of non-epithelial rare germ cell tumors (GCT) and sex cord stromal tumors are associated with long survival. They mainly include conservative surgery plus chemotherapy (CT) [bleomycin, etoposide and cisplatin (BEP)] depending on stage and prognostic factors. As reported in testicular cancer survivors, BEP may induce late side effects with negative impact on quality-of-life (QOL). The French Rare Malignant Gynecological Tumors (TMRG)/GINECO case-control study assessed long term QOL among survivors treated with BEP as compared to age-matched healthy women (HW).

Methodology Non-epithelial ovarian cancer survivors (nEOCS), cancer-free ≥2 years after end of treatment, were identified from the INCa French Network for TMRG. HW were issued from the ‘Seintinelles’ research platform. QOL (FACT-G/FACT-O), chronic fatigue (MFI), anxiety/depression (HADS), insomnia (ISI), neurotoxicity (FACT/GOG-NTX), cognition (FACT-COG) and sexuality items (from FACT-O OCS) were compared between nEOCS and HW. A minimal 5% difference of scores between groups was considered as clinically relevant.

Results 144 nEOCS (including 112 GCT) plus 144 age-matched HW were enrolled (mean age at inclusion: 38; 60% <40). Median delay from the end of treatments to inclusion was 6 yrs. At inclusion, 42% of nEOCS were menopausal versus 17% of HW (p<0.001). General and ovarian QOL, fatigue, anxiety/depression and insomnia scores were similar between nEOCS and HW. Although nEOCS reported clinically significant (6%) better social functioning (p=0.006), nEOCS reported more perceived cognitive impairment than HW (31 vs 14%, p<0.001) and clinically significant (8%) neurotoxicity (p<0.001). They also reported less interest in sex (35% vs 55%, p<0.001) and more concern of childlessness (31% vs 13%, p=0.007) than HW, whatever the menopausal status.

Conclusion 6 yrs after BEP CT, most of nEOCS reported similar global QOL as HW, but they experienced more often premature menopause, some late side effects on cognition, neurotoxicity and sexuality that may impact their daily life.

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