Life after endometrial cancer: A systematic review of patient-reported outcomes

Robert Shisler; Jennifer A Sinnott; Vivian Wang; Courtney Hebert; Ritu Salani; Ashley S Felix

doi:10.1016/j.ygyno.2017.11.007

Life after endometrial cancer: A systematic review of patient-reported outcomes

Gynecol Oncol. 2018 Feb;148(2):403-413. doi: 10.1016/j.ygyno.2017.11.007. Epub 2017 Nov 14.

Authors

Robert Shisler¹, Jennifer A Sinnott², Vivian Wang¹, Courtney Hebert³, Ritu Salani⁴, Ashley S Felix⁵

Affiliations

¹ Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States.
² Department of Statistics, College of Arts and Sciences, The Ohio State University, Columbus, OH, United States.
³ Division of Bioinformatics, College of Medicine, The Ohio State University, Columbus, OH, United States.
⁴ Division of Gynecologic Oncology, College of Medicine, The Ohio State University, Columbus, OH, United States.
⁵ Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States. Electronic address: Felix.20@osu.edu.

PMID: 29150143
DOI: 10.1016/j.ygyno.2017.11.007

Abstract

Background: Women with endometrial cancer (EC) are the second largest population of female cancer survivors in the United States. However, the outcomes of EC survivors, from the patient perspective, are not well-understood. Therefore, we conducted a systematic review of patient-reported outcomes (PROs) following an EC diagnosis.

Methods: We searched MEDLINE, EMBASE, Scopus, CINAHL, and reference lists to identify published observational studies that examined PROs among women with EC. Reviewers independently reviewed eligible full-text study articles and conducted data extraction. We qualitatively summarized included articles according to exposures [e.g. body mass index (BMI), treatment, etc.] or specific PROs (e.g. sexual function).

Results: Of 1722 unique studies, 102 full-text articles were reviewed, of which a total of 27 studies fulfilled the inclusion criteria. The most commonly used PRO questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) (n=9), Short Form 36 Questionnaire (SF-36, n=8), the Functional Assessment of Cancer Therapy-General (FACT-G, n=5), and the Female Sexual Function Index (FSFI, n=4). Obesity was associated with lower quality of life (QOL) and physical functioning. Treatment type affected several outcomes. Laparoscopy generally resulted in better QOL outcomes than laparotomy. Likewise, vaginal brachytherapy was associated with better outcomes compared to external beam radiation. Sexual function outcomes were dependent on age, time since diagnosis, and having consulted a physician before engaging in sexual activities. In addition, a physical activity intervention was associated with improved sexual interest but not sexual function.

Conclusions: Our review provides insight into the experience of EC survivors from the patient perspective. Factors that contribute to QOL, such as pain, fatigue, emotional and social functioning, should be monitored following an EC diagnosis.

Keywords: Endometrial cancer; Obesity; Patient reported outcome; Quality of life; Sexual function; Survivor.

Publication types

Review
Systematic Review

MeSH terms

Body Weight / physiology
Cancer Survivors / psychology*
Endometrial Neoplasms / complications
Endometrial Neoplasms / psychology*
Endometrial Neoplasms / therapy
Exercise / psychology
Female
Humans
Obesity / complications
Obesity / psychology
Observational Studies as Topic
Patient Reported Outcome Measures*
Quality of Life*
Sexual Behavior
Surveys and Questionnaires