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Quality of life and long-term clinical outcome following robot-assisted radical trachelectomy

Ekdahl, Linnea LU orcid ; Crusensvärd, Malin ; Reynisson, Petur LU ; Lönnerfors, Celine LU and Persson, Jan LU (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.

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author
; ; ; and
organization
publishing date
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
  • scopus:85119583616
  • pmid:34837852
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
2024-06-15 22:16:38
@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}},
}