Quality of life after treatment for gynecologic malignancies: a pilot study in an outpatient clinic.

Abstract

The objective of this study was to determine the health-related quality of life (QOL) of disease-free patients after therapy for gynecologic malignancies at follow-up in an outpatient clinic. Eighty-five patients (P) completed the general Functional Assessment of Cancer Therapy (FACT-G) QOL questionnaire at least 6 months after treatment for a gynecologic malignancy. Responses were compared to 42 unmatched healthy women (H) who were seen for standard gynecologic screening exams. Statistical evaluation was done using t tests, chi(2),and Wilcoxon rank-sum tests, Spearman rank correlations, and linear regression. The demographic data for the groups were as follows: median age P, 59 years; H, 56 years; Caucasian P, 51%; H, 56%, African American P, 49%; H, 44%, cervix cancer (n = 51, 60%), uterine cancer (n = 24, 28%), ovarian cancer (n = 10, 12%). The median time since therapy was 39 months (range 6-149 months). There were no overall differences in FACT-G scores of patients and healthy women. Cancer survivors scored slightly higher on the emotional well-being subscale (mean 20.4 vs 19.2). Among cancer patients, all scores were lowest in patients with ovarian cancer. Longer treatment time was associated with a lower physical well-being. Older patients scored higher on emotional well-being, but lower on social/family well-being. Poor education and no help at home were associated with lower functional well-being and total FACT scores. Linear regression analysis revealed significantly lower total QOL scores in patients with the following characteristics: ovarian cancer diagnosis, treatment with radiation therapy or multi-modality therapy, less than high school education, and lack of help at home. Overall the recovery from treatment for gynecological cancer is good. Patients with ovarian cancer, prolonged therapy, poor education, and little social support have the most significant impairments in health-related quality of life and need additional support resources.