A prospective study of quality of life in patients undergoing pelvic exenteration: Interim results

作者：Rezk Youssef A; Hurley Karen E; Carter Jeanne; Dao Fanny; Bochner Bernard H; Aubey Janice J; Caceres Aileen; Einstein M Heather; Abu Rustum Nadeem R; Barakat Richard R; Makker Vicky; Chi Dennis S^*

来源：Gynecologic Oncology, 2013, 128(2): 191-197.

DOI：10.1016/j.ygyno.2012.09.030

• Pelvic exenteration
• Quality of life

Objective. Little prospective data exist on quality of life (QOL) after pelvic exenteration (PE). This ongoing study prospectively examines the QOL changes following this radical procedure using a comprehensive battery of psychological instruments. %26lt;br%26gt;Methods. Since 2005, enrolled patients were interviewed (EORTC QLQ-C30, EORTC QLQ-CR38, EORTC QLQ-BLM30, BFI, BPI-SF, IADL, CES-D, IES-R) preoperatively and at 3, 6, and 12 months after PE for physical/psychological symptoms. Data were examined using repeated measure ANOVA. %26lt;br%26gt;Results. Sixteen women (3 anterior, 1 posterior, and 12 total PEs), with more than 1 year of follow-up, completed all scheduled interviews. Median age was 58 years (range, 28-76 years). Overall QOL (F=6.3, p%26lt;0.02), ability to perform instrumental daily activities (F=6.8, p%26lt;0.02), body image (F=11.9, p%26lt;0.00), and sexual F=8.0, p%26lt;0.01) all declined at 3 months but were near baseline by 12 months after PE. Although, overall, physical function followed a similar trend (F=14.8, p%26lt;0.00), it did not return to baseline. At the 12-month interview, patients reported increased gastrointestinal symptoms (F=8.9, p%26lt;0.01) but significantly less stress-related ideation (F=6.1, p%26lt;0.03) compared to baseline. Pain levels did not change significantly during the study period (F=0.4, p%26lt;0.74). %26lt;br%26gt;Conclusions. Although patients report lingering gastrointestinal symptoms and some persistent decline in physical function after PE, most adjust well, returning to almost baseline functioning within a year. Providers can counsel patients that many, though not all, symptoms in the first 3 months following exenteration are likely to improve as they adapt to their changed health status. These preliminary results await confirmation of a larger analysis.

• 出版日期2013-2