Quality of life research in endometrial cancer: what is needed to advance progress in this disease site? Methodological considerations from the Gynecologic Cancer InterGroup Symptom Benefit Working Group brainstorming session, Leiden 2012

BACKGROUND

Quality of life (QoL) in endometrial cancer (EC) is understudied. Incorporation of QoL questionnaires and patient-reported outcomes in clinical trials has been inconsistent, and the tools and interpretation of these measures are unfamiliar to most practitioners. In 2012, the Gynecologic Cancer InterGroup Symptom Benefit Working Group convened for a brainstorming collaborative session to address deficiencies and work toward improving the quality and quantity of QoL research in women with EC.

METHODS

Through literature review and international expert contributions, we compiled a comprehensive appraisal of current generic and disease site-specific QoL assessment tools, strengths and weaknesses of these measures, assessment of sexual health, statistical considerations, and an exploration of the unique array of histopathologic and clinical factors that may influence QoL outcomes in women with EC.

RESULTS

This collaborative composition is the first publication specific to EC that addresses methodology in QoL research and the components necessary to achieve high quality QoL data in clinical trials. Future recommendations regarding (1) the incorporation of patient-reported outcomes in all clinical trials in EC, (2) definition of an a priori hypothesis, (3) utilization of validated tools and consideration of new tools corresponding to new therapies or specific symptoms, (4) publication within the same time frame as clinical outcome data, and (5) attempt to correct for disease site-specific potential confounders are presented.

CONCLUSIONS

Improved understanding of methodology in QoL research and an increased undertaking of EC-specific QoL research in clinical trials are imperative if we are to improve outcomes in women with EC.

[Health-related quality of life in patients treated for ovarian cancer: tools and issues]

Health-related quality of life (QoL) in patients treated for ovarian cancer is directly and heavily impacted by the natural history of cancer, its evolution and its therapeutic modalities. The evaluation and consideration of various parameters of QoL seems to be a major issue. Indeed, on the one hand, it is essential to take into account the opinion of patients in the choice of therapeutic strategies for this cancer with a poor prognosis and, on the other hand, more and more studies show that QoL is an independent prognostic factor in ovarian cancer. Improvement in this case, in addition to being an endpoint by itself, would potentially improve the overall survival of patients. To date there are several tools to assess QOL of patients with ovarian cancer. The 2 questionnaires most commonly used are: FACT-O and the EORTC QLQ-OV28. The aim of our study was to evaluate from a review of the literature, the reciprocal effects of ovarian cancer on QoL and QoL on ovarian cancer survival, as well as specificities of each of the 2 questionnaires most commonly used in assessing the QoL.

Longitudinal assessment of quality of life in ovarian cancer patients

OBJECTIVE

The objective of this work was to evaluate longitudinally the quality of life (QOL) in women treated for ovarian cancer, pre-operatively, three and six months postoperatively.

METHODS

A longitudinal cohort study. A total of 93 patients with newly diagnosed ovarian cancer in F. Chopin Voivodeship Specialist Hospital in Rzeszow, Poland were interviewed pre- and post-operatively with two questionnaires: EORTC QLQ-C30 and QLQ- OV28 between October 2006 and December 2008.

RESULTS

Based on EORTC QLQ-30 it was found that global health and emotional functioning improved. An improvement regarding symptoms such as nausea and vomiting was recorded between T2 and T3. Patients complained less of pain in the whole studied period of time. Based on the modules of the QLQ-OV28 showed improvement of QOL on the scales concerning abdominal and attitude to disease/treatment. Decrease of symptoms on the scales concerning body image and sexual worries were observed. Increase of chemotherapy side effects and hormonal symptoms were observed between T1 and T2, but then improved.

CONCLUSIONS

QOL of patients had increased after the treatment in comparison to the baseline. There is a need to implement the assessment of quality of life in ovarian cancer patients in practice.