Comparative patient-centered outcomes (health state and adverse sexual symptoms) between adjuvant brachytherapy versus no adjuvant brachytherapy in early stage endometrial cancer Journal Article


Authors: Damast, S.; Alektiar, K.; Eaton, A.; Gerber, N. K.; Goldfarb, S.; Patil, S.; Jia, R.; Leitao, M.; Carter, J.; Basch, E.
Article Title: Comparative patient-centered outcomes (health state and adverse sexual symptoms) between adjuvant brachytherapy versus no adjuvant brachytherapy in early stage endometrial cancer
Abstract: Purpose. To determine a relationship between sexual functioning and health state among survivors of stage I endometrial cancer, and to examine whether adjuvant intravaginal radiotherapy (IVRT) affects these measures compared to hysterectomy alone. Methods. Two hundred five survivors (>1 year from surgery) completed questionnaires containing the EuroQol (EQ5D) and the Female Sexual Function Index (FSFI). A total of 136 (66.3 %) underwent surgery alone, and 69 (33.7 %) received IVRT. Pearson correlation was used to correlate FSFI and EQ5D-Health State scores. Multivariable regression was performed to measure the impact of IVRT on sexual functioning and health state. Results. A majority of patients (80 %) met criteria for sexual dysfunction by FSFI < 26.5. A significant correlation was detected between FSFI and EQ5D scores (Pearson correlation = 0.21, p = 0.003). Compared to the IVRT group, the surgery group was younger (p = 0.001) and trended toward more frequent use of minimally invasive surgery versus laparotomy (p = 0.08). Otherwise, the two groups were well balanced with respect to demographics, comorbidities, and baseline sexual activity. Controlling for age and surgery type, IVRT was not associated with poorer health state or sexual function. Receipt of laparotomy was associated with both poorer health state and sexual function (p = 0.0156 and p = 0.0247, respectively). Conclusions. Sexual functioning was generally poor among endometrial cancer survivors; however, those with improved FSFI scores tended to have superior health states. IVRT was not a significant risk factor; however, receipt of laparotomy appeared to be associated with poorer sexual functioning and health state. © 2014 Society of Surgical Oncology.
Keywords: adult; controlled study; aged; cancer surgery; major clinical study; multimodality cancer therapy; cancer adjuvant therapy; cancer radiotherapy; cancer staging; outcome assessment; hysterectomy; endometrium cancer; laparotomy; female sexual dysfunction; estrogen; dyspareunia; sexual satisfaction; medical record review; cancer survivor; questionnaire; patient care; sexuality; health status; karnofsky performance status; dosimetry; early cancer; minimally invasive surgery; visual analog scale; sexual function; sexual behavior; hormone substitution; self care; female sexual function index; comparative effectiveness; orgasm; lubricating agent; sexual counseling; sexual arousal; vaginal lubrication; human; female; article; intravaginal radiotherapy; radiotherapy unit
Journal Title: Annals of Surgical Oncology
Volume: 21
Issue: 8
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2014-08-01
Start Page: 2740
End Page: 2754
Language: English
DOI: 10.1245/s10434-014-3562-4
PROVIDER: scopus
PUBMED: 24619493
DOI/URL:
Notes: Export Date: 2 September 2014 -- CODEN: ASONF -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    386 Patil
  2. Kaled M Alektiar
    253 Alektiar
  3. Xiaoyu Jia
    44 Jia
  4. Mario Leitao
    309 Leitao
  5. Naamit Kurshan Gerber
    18 Gerber
  6. Jeanne Carter
    109 Carter
  7. Anne Austin Eaton
    117 Eaton