A longitudinal study on quality of life after gynecologic cancer treatment

Objective. The objective was to describe the pattern of quality of life (QO L) 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 assess ed before treatment, after completion of treatment, and at 6, 12, and 24 mo nths. Spearman's correlation analyses were performed. A mixed effect model was fitted to the data. Bonferroni pairwise comparisons were used to analyz e the different variables. Results. One hundred forty-four women completed the study. Overall QOL impr oved 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 correlat ion for all time points in most factors, indicating that the global health status, functional scales, and symptom scales exhibit a dependent change ov er time. Relief in symptoms was associated with improvements in functional scales. The scores on overall QOL were lower for younger patients and for p atients treated with chemotherapy than for patients treated with surgery. Conclusions. Strategies for supportive care need to focus on symptom manage ment. Psychosocial interventions, to be effective, should include all patie nts and should aim to reduce the impact of treatment on the individual pati ent. (C) 2001 Academic Press.