Mild symptoms matter: Results from a prospective, longitudinal study on the relationship between symptoms, lymphedema and health-related outcomes post-gynecological cancer

IF 4.5 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Gynecologic oncology Pub Date : 2024-10-18 DOI:10.1016/j.ygyno.2024.10.011
Melanie L. Plinsinga , Sheree Rye , Tamara Jones , Dimitrios Vagenas , Leigh Ward , Monika Janda , Andreas Obermair , Sandra C. Hayes
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Abstract

Objectives

To describe lower-limb symptoms pre- through to 2-years post-surgery following newly diagnosed gynecological cancer; to explore relationships between lower-limb symptoms, lower-limb lymphedema, body image, quality of life, anxiety and depression; and to determine whether lower-limb symptoms predict lower-limb lymphedema.

Methods

Fourteen lower-limb symptoms, lymphedema, body image, anxiety, depression, and quality of life were prospectively collected in 408 women with gynecological cancer pre-surgery, and at 6-, 12-, and 24-months post-surgery. Point prevalence and cumulative incidence were calculated for symptoms. Cross-sectional relationships were explored between symptoms, lower-limb lymphedema and health-related outcomes at all timepoints, while regression analyses were used to assess the predictive relationships between lower-limb symptoms at 6-months post-surgery, and lymphedema at 12- and 24-months post-surgery.

Results

Participants were on average 59 (SD: 11) years of age, and 58 %, 28 %, 9 % and 5 % were diagnosed with endometrial, ovarian, cervical, and vulvar/vaginal cancer, respectively. Prevalence of any given lower limb symptom among all cancer types ranged between 11 and 59 %, with the most prevalent symptoms being pain, stiffness, and aching (prevalence >40 % across all time-points). The presence of symptoms was associated with higher anxiety and depression, poorer overall quality of life and body image (p < 0.01). Compared to those without symptoms, one or more lower limb symptoms of at least mild severity increased the odds of developing lymphedema up to 24 months post-surgery (OR > 1.3).

Conclusions

Self-reported symptoms are associated with adverse health-related outcomes. Assessment and management of symptoms, irrespective of symptom severity, has potential for improving health outcomes, including lymphedema, in those following gynecological cancer.
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轻微症状很重要:妇科癌症术后症状、淋巴水肿和健康相关结果之间关系的前瞻性纵向研究结果
目的描述新确诊妇科癌症术前至术后两年的下肢症状;探讨下肢症状、下肢淋巴水肿、身体形象、生活质量、焦虑和抑郁之间的关系;确定下肢症状是否可预测下肢淋巴水肿。方法前瞻性地收集了 408 名妇科癌症妇女在手术前、手术后 6 个月、12 个月和 24 个月时的 14 种下肢症状、淋巴水肿、身体形象、焦虑、抑郁和生活质量。计算了症状的点流行率和累积发生率。研究人员探讨了所有时间点的症状、下肢淋巴水肿和健康相关结果之间的横断面关系,并使用回归分析评估了手术后 6 个月的下肢症状与手术后 12 个月和 24 个月的淋巴水肿之间的预测关系。结果参与者的平均年龄为59岁(标准差:11岁),被诊断患有子宫内膜癌、卵巢癌、宫颈癌和外阴/阴道癌的比例分别为58%、28%、9%和5%。在所有癌症类型中,任何一种下肢症状的发病率在11%到59%之间,最常见的症状是疼痛、僵硬和酸痛(在所有时间点的发病率为40%)。出现症状与较高的焦虑和抑郁、较差的整体生活质量和身体形象有关(p <0.01)。与无症状者相比,一种或多种至少轻度的下肢症状会增加术后 24 个月内发生淋巴水肿的几率(OR > 1.3)。无论症状严重程度如何,对症状进行评估和管理都有可能改善妇科癌症患者的健康状况,包括淋巴水肿。
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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