Abstract
Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. A prospective study with women submitted to radical hysterectomy (RH) (n = 20), exclusive radiotherapy (RT) (n = 20) or chemoradiation (CT/RT) (n = 20) for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor muscle contraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05). The groups were similar in stress urinary incontinence incidence (p = 0.56), urinary urgency (p = 0.44), urge incontinence (p = 0.54), nocturia (p = 0.53), incomplete bowel emptying (p = 0.76), bowel urgency (p = 0.12) and soilage (p = 0.43). The CT/RT group presented a higher urinary frequency (p < 0.001) and diarrhea (p = 0.025). Patients in the RH group were more sexually active (p = 0.01) and experienced less dyspareunia (p = 0.021). Vaginal length was shorter in RT group (5.5 ± 1.9 cm) and CT/RT(5.3 ± 1.5 cm) than in the RH group (7.4 ± 1.1 cm) (p < 0.001). Pelvic floor muscle contraction was similar (p = 0.302). RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.
Highlights
Cancer of the cervix is the second most common cancer among women worldwide, with an estimated 493,000 new cases and 274,000 deaths [1]
When different treatment options result in equivalent clinical outcomes, quality of life (QoL) considerations become important [4]
In the management of cervical cancer, attention has turned to reducing morbidity, especially those related to the pelvic organs [2]
Summary
Cancer of the cervix is the second most common cancer among women worldwide, with an estimated 493,000 new cases and 274,000 deaths [1]. The introduction of screening programs has resulted in the earlier detection of the disease [2] leading to the majority of cervical carcinoma patients diagnosed at a relatively young age. The primary treatment for patients with cervical cancer depends on a variety of factors, including staging, tumor characteristics, comorbid medical conditions, and patient and provider preference [4]. The addition of chemotherapy to radiotherapy (chemoradiation CT/RT) results in an absolute improvement in overall survival and a significant reduction in local recurrence for all stages of disease [6,7,8]
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