A longitudinal study on quality of life after gynecologic cancer treatment

Objective. The objective was to describe the pattern of quality of life (QOL) over time and to assess the impact of age, symptoms, disease parameters, and treatment on the overall QOL. Methods. A longitudinal study on patients with newly diagnosed gynecologic cancer using individual patients as their own control was performed. The 33-item EORTC QLQ-C30((+3)) was used as the QOL measure. Patients were assessed before treatment, after completion of treatment, and at 6, 12, and 24 months. Spearman's correlation analyses were performed. A mixed effect model was fitted to the data. Bonferroni pairwise comparisons were used to analyze the different variables. Results. One hundred forty-four women completed the study. Overall QOL improved after the completion of treatment but remained the same throughout the 2 years after treatment. The individual patient's QOL before treatment was insignificant while the impact of treatment on the individual patient was significant in determining QOL after treatment. There was a strong correlation for all time points in most factors, indicating that the global health status, functional scales, and symptom scales exhibit a dependent change over time. Relief in symptoms was associated with improvements in functional scales. The scores on overall QOL were lower for younger patients and for patients treated with chemotherapy than for patients treated with surgery. Conclusions. Strategies for supportive care need to focus on symptom management. Psychosocial interventions, to be effective, should include all patients and should aim to reduce the impact of treatment on the individual patient. (C) 2001 Academic Press.