Impact of Various Treatment Modalities on Long-Term Quality of Life in Cervical Cancer Survivors

Introduction Given treatment advancements and the long life expectancy of mostly young patients with cervical cancer, their post-treatment quality of life (QoL) is essential to consider. This study aimed to evaluate the long-term QoL in cervical cancer survivors treated with various approaches. Methods We conducted a cross-sectional survey-based study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cervical Cancer Module 24 (EORTC-QLQ-CX24) questionnaires and involved members of the online cervical cancer patient support group (01/2024-02/2024). Eligible participants were >= 18 years old, diagnosed with stage IA2-IIB cervical cancer, and had completed their treatment. Respondents were stratified into four management groups: neoadjuvant chemotherapy + surgery +/- radiation therapy (RT), surgery + RT, RT alone, and surgery alone. Results Overall, 173 patients participated: 20 (11.6%) received neoadjuvant chemotherapy + surgery +/- RT, 50 (28.9%) had surgery + RT, 69 (39.9%) had RT alone, and 34 (19.7%) had surgery alone. Patients after surgery alone had significantly better global QoL (p<0.001). Their physical (p<0.001), role (p=0.037), emotional (p=0.024), and social (p=0.006) functioning were also substantially better. This group also reported the lowest severity of fatigue (p=0.001), nausea and vomiting (p<0.001), and diarrhea (p<0.001). Sexual functioning was better in the surgery-alone group in almost all aspects. There were no major differences in QoL among the groups, receiving RT alone or combined with other treatments. Conclusions Cervical cancer survivors who underwent surgery alone reported the highest QoL and lower symptom intensity compared to those treated with RT or treatment combinations. RT combined with other modalities did not appear to substantially decrease QoL compared to RT alone.