Quality of life after treatment for gynecologic malignancies: a pilot study in an outpatient clinic.

OBJECTIVE: The objective of this study was to determine the health-related quality of life (QOL) of disease-free patients after therapy for gynecologic malignancies at follow-up in an outpatient clinic.

METHODS: Eighty-five patients (P) completed the general Functional Assessment of Cancer Therapy (FACT-G) QOL questionnaire at least 6 months after treatment for a gynecologic malignancy. Responses were compared to 42 unmatched healthy women (H) who were seen for standard gynecologic screening exams. Statistical evaluation was done using t tests, chi(2),and Wilcoxon rank-sum tests, Spearman rank correlations, and linear regression.

RESULTS: The demographic data for the groups were as follows: median age P, 59 years; H, 56 years; Caucasian P, 51%; H, 56%, African American P, 49%; H, 44%, cervix cancer (n = 51, 60%), uterine cancer (n = 24, 28%), ovarian cancer (n = 10, 12%). The median time since therapy was 39 months (range 6-149 months). There were no overall differences in FACT-G scores of patients and healthy women. Cancer survivors scored slightly higher on the emotional well-being subscale (mean 20.4 vs 19.2). Among cancer patients, all scores were lowest in patients with ovarian cancer. Longer treatment time was associated with a lower physical well-being. Older patients scored higher on emotional well-being, but lower on social/family well-being. Poor education and no help at home were associated with lower functional well-being and total FACT scores. Linear regression analysis revealed significantly lower total QOL scores in patients with the following characteristics: ovarian cancer diagnosis, treatment with radiation therapy or multi-modality therapy, less than high school education, and lack of help at home.

CONCLUSION: Overall the recovery from treatment for gynecological cancer is good. Patients with ovarian cancer, prolonged therapy, poor education, and little social support have the most significant impairments in health-related quality of life and need additional support resources.