Quality of life and long-term clinical outcome following robot-assisted radical trachelectomy
(2021) In European Journal of Obstetrics and Gynecology and Reproductive Biology 267. p.234-240- Abstract
Quality of Life and long-term clinical outcome following robot-assisted radical trachelectomy. Objectives: To evaluate quality of life (QoL) and long-term clinical outcome following robot-assisted radical trachelectomy (RRT). Study Design: Prospectively retrieved clinical data were rereviewed on all women planned for a fertility sparing RRT for early stage cervical cancer at Skåne University Hospital, Sweden between 2007 and 2020. QoL was assessed using the validated questionnaires EORTC QLQ-C30, QLQ-CX24 and the Swedish LYMQOL. Results: Data was analyzed from 49 women, 42 with a finalised RRT and seven with an aborted RRT due to nodal metastases (n = 3) or insufficient margins (n = 4). At a median follow-up time of 54 months one... (More)
Quality of Life and long-term clinical outcome following robot-assisted radical trachelectomy. Objectives: To evaluate quality of life (QoL) and long-term clinical outcome following robot-assisted radical trachelectomy (RRT). Study Design: Prospectively retrieved clinical data were rereviewed on all women planned for a fertility sparing RRT for early stage cervical cancer at Skåne University Hospital, Sweden between 2007 and 2020. QoL was assessed using the validated questionnaires EORTC QLQ-C30, QLQ-CX24 and the Swedish LYMQOL. Results: Data was analyzed from 49 women, 42 with a finalised RRT and seven with an aborted RRT due to nodal metastases (n = 3) or insufficient margins (n = 4). At a median follow-up time of 54 months one recurrence (2%) occurred (aborted RRT). According to QLQ-C30 the median global health status score was 75. The disease specific QLQ-C24 showed an impact on symptoms related to sexual function where sexual/vaginal functioning had a median score of 25 and 48% of patients reported worry that sex would cause physical pain. Despite this the functional items sexual activity and sexual enjoyment both had a median score of 66.7. Lymphoedema was reported in 45%, where 9% reported severe symptom with an impact on their QoL. No intraoperative complications and no postoperative complications ≥ Clavien Dindo grade III were observed. Twenty-two of 28 (79%) women who attempted to conceive were successful. A metronidazole/no intercourse regimen was applied between GW 15 + 0–21 + 6 in 26 of 28 pregnancies beyond first trimester resulting in a 92% term (≥GW 36 + 0) delivery rate. Conclusions: Although robot-assisted radical trachelectomy in this cohort was associated with a low recurrence rate, a high fertility rate and an exceptionally high term delivery rate, women's quality of life was affected postoperatively, particularly with regards to their sexual well-being and lymphatic side-effects.
(Less)
- author
- Ekdahl, Linnea LU ; Crusensvärd, Malin ; Reynisson, Petur LU ; Lönnerfors, Celine LU and Persson, Jan LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Lymphedema, Quality of Life, Robot-assisted radical trachelectomy, Sexual function
- in
- European Journal of Obstetrics and Gynecology and Reproductive Biology
- volume
- 267
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:34837852
- scopus:85119583616
- ISSN
- 0301-2115
- DOI
- 10.1016/j.ejogrb.2021.11.018
- language
- English
- LU publication?
- yes
- id
- 349115f6-a7d2-44df-a600-18e77ccded14
- date added to LUP
- 2021-12-08 13:35:07
- date last changed
- 2024-08-25 05:06:52
@article{349115f6-a7d2-44df-a600-18e77ccded14, abstract = {{<p>Quality of Life and long-term clinical outcome following robot-assisted radical trachelectomy. Objectives: To evaluate quality of life (QoL) and long-term clinical outcome following robot-assisted radical trachelectomy (RRT). Study Design: Prospectively retrieved clinical data were rereviewed on all women planned for a fertility sparing RRT for early stage cervical cancer at Skåne University Hospital, Sweden between 2007 and 2020. QoL was assessed using the validated questionnaires EORTC QLQ-C30, QLQ-CX24 and the Swedish LYMQOL. Results: Data was analyzed from 49 women, 42 with a finalised RRT and seven with an aborted RRT due to nodal metastases (n = 3) or insufficient margins (n = 4). At a median follow-up time of 54 months one recurrence (2%) occurred (aborted RRT). According to QLQ-C30 the median global health status score was 75. The disease specific QLQ-C24 showed an impact on symptoms related to sexual function where sexual/vaginal functioning had a median score of 25 and 48% of patients reported worry that sex would cause physical pain. Despite this the functional items sexual activity and sexual enjoyment both had a median score of 66.7. Lymphoedema was reported in 45%, where 9% reported severe symptom with an impact on their QoL. No intraoperative complications and no postoperative complications ≥ Clavien Dindo grade III were observed. Twenty-two of 28 (79%) women who attempted to conceive were successful. A metronidazole/no intercourse regimen was applied between GW 15 + 0–21 + 6 in 26 of 28 pregnancies beyond first trimester resulting in a 92% term (≥GW 36 + 0) delivery rate. Conclusions: Although robot-assisted radical trachelectomy in this cohort was associated with a low recurrence rate, a high fertility rate and an exceptionally high term delivery rate, women's quality of life was affected postoperatively, particularly with regards to their sexual well-being and lymphatic side-effects.</p>}}, author = {{Ekdahl, Linnea and Crusensvärd, Malin and Reynisson, Petur and Lönnerfors, Celine and Persson, Jan}}, issn = {{0301-2115}}, keywords = {{Lymphedema; Quality of Life; Robot-assisted radical trachelectomy; Sexual function}}, language = {{eng}}, pages = {{234--240}}, publisher = {{Elsevier}}, series = {{European Journal of Obstetrics and Gynecology and Reproductive Biology}}, title = {{Quality of life and long-term clinical outcome following robot-assisted radical trachelectomy}}, url = {{http://dx.doi.org/10.1016/j.ejogrb.2021.11.018}}, doi = {{10.1016/j.ejogrb.2021.11.018}}, volume = {{267}}, year = {{2021}}, }