Quality of life and survival in patients with uterine carcinosarcoma: A tertiary center observational study

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY Gynecologic Oncology Reports Pub Date : 2025-02-01 DOI:10.1016/j.gore.2025.101679
Eveline N.B. Pham , Caroline B. van den Berg , Ingrid Boere , Vera de Geus , Juanita A. Haagsma , Marianne Maliepaard , Jan Willem M. Mens , Floris H. Groenendijk , Heleen J. van Beekhuizen
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Abstract

Objective

This study aimed to assess the QoL in patients with uterine carcinosarcoma (UCS) and identify factors influencing survival.

Methods

A prospective cohort study was conducted of patients with UCS who were treated between 2016 and 2022 in a Dutch academic hospital. QoL was evaluated using the EORTC QLQ-C30 and QLQ-EN24 questionnaires at baseline, end of treatment, and at one, two, and five years after treatment. Outcomes were described as mean scores in functioning and symptom domains. The mean scores of the QLQ-C30 were compared to those of a matched group from the general Dutch population. Clinical data were collected. Factors influencing survival were assessed via Cox proportional hazards models.

Results

The study included 64 patients, 56 of them participated in the QoL questionnaires. The median progression-free survival was 13 months, and overall survival was 20 months. QoL was significantly lower in all functional domains at one year after treatment compared to members of the general population. The most affected functioning domains were physical, role, cognitive, and social functioning and symptoms like fatigue, pain, and lymphedema. Long-term QoL remained compromised, with global health and insomnia notably impaired even five years after treatment. Significant prognostic factors for better overall survival included lower FIGO stage, surgery, and chemotherapy.

Conclusions

Patients with UCS experience significant deterioration in QoL. Despite extensive treatment, QoL remains poor, emphasizing the need for integrating QoL considerations into treatment decisions to balance the benefits of treatment with potential QoL impairments.

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子宫癌肉瘤患者的生活质量和生存:一项三级中心观察性研究。
目的:评价子宫癌肉瘤(UCS)患者的生活质量,探讨影响生存的因素。方法:对2016年至2022年在荷兰一家学术医院接受治疗的UCS患者进行前瞻性队列研究。在基线、治疗结束、治疗后1年、2年和5年,使用EORTC QLQ-C30和QLQ-EN24问卷评估生活质量。结果描述为功能和症状领域的平均得分。研究人员将QLQ-C30的平均得分与荷兰普通人群中的匹配组进行了比较。收集临床资料。通过Cox比例风险模型评估影响生存的因素。结果:共纳入64例患者,其中56例患者参与了生活质量问卷调查。中位无进展生存期为13个月,总生存期为20个月。治疗一年后,与普通人群相比,所有功能领域的生活质量明显降低。最受影响的功能领域是身体、角色、认知和社会功能,以及疲劳、疼痛和淋巴水肿等症状。长期生活质量仍然受到损害,即使在治疗五年后,整体健康和失眠也明显受损。提高总生存率的重要预后因素包括较低的FIGO分期、手术和化疗。结论:UCS患者生活质量明显恶化。尽管进行了广泛的治疗,但生活质量仍然很差,这强调了将生活质量考虑纳入治疗决策的必要性,以平衡治疗的益处和潜在的生活质量损害。
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来源期刊
Gynecologic Oncology Reports
Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-
CiteScore
2.00
自引率
0.00%
发文量
183
审稿时长
41 days
期刊介绍: Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.
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