Long-term quality of life after comprehensive surgical staging of high-risk endometrial cancer – results from the RASHEC trial

Authors

  • Sahar Salehi Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; ;Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
  • Yvonne Brandberg Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  • Elisabeth Åvall-Lundqvist Department of Oncology, Linköping University, Linköping, Sweden; ;Department of Clinical Experimental Medicine, Linköping University, Linköping, Sweden
  • Chikako Suzuki Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; ;Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden
  • Hemming Johansson Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  • Berit Legerstam Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
  • Henrik Falconer Division of Obstetrics and Gynecology, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden; ;Theme Cancer, Karolinska University Hospital, Stockholm, Sweden

DOI:

https://doi.org/10.1080/0284186X.2018.1521987

Abstract

Purpose: The health-related quality of life (HRQoL) outcomes after comprehensive surgical staging including infrarenal paraaortic lymphadenectomy in women with high-risk endometrial cancer (EC) are unknown. Our aim was to investigate the long-term HRQoL between robot-assisted laparoscopic surgery (RALS) and laparotomy (LT).

Patients and Methods: A total of 120 women with high-risk stage I-II EC were randomised to RALS or LT for hysterectomy, bilateral salpingoophorectomy, pelvic and infrarenal paraaortic lymphadenectomy in the previously reported Robot-Assisted Surgery for High-Risk Endometrial Cancer trial. The HRQoL was measured with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-30) and its supplementary questionnaire module for endometrial cancer (QLQ-EN24) questionnaire. Women were assessed before and 12 months after surgery. In addition, the EuroQol Eq5D non-disease specific questionnaire was used for descriptive analysis.

Results: There was no difference in the functional scales (including global health status) in the intention to treat analysis, though LT conferred a small clinically important difference (CID) over RALS in ‘cognitive functioning’ albeit not statistically significant −6 (95% CI−14 to 0, p = .06). LT conferred a significantly better outcome for the ‘nausea and vomiting’ item though it did not reach a CID, 4 (95% CI 1 to 7, p = .01). In the EORTC-QLQ/QLQ-EN24, no significant differences were observed. Eq5D-3L questionnaire demonstrated a higher proportion of women reporting any extent of mobility impairment 12 months after surgery in the LT arm (p = .03).

Conclusion: Overall, laparotomy and robot-assisted surgery conferred similar HRQoL 12 months after comprehensive staging for high-risk EC.

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Published

2018-12-02

How to Cite

Salehi, S. ., Brandberg, Y. ., Åvall-Lundqvist, E. ., Suzuki, C. ., Johansson, H. ., Legerstam, B. ., & Falconer, H. . (2018). Long-term quality of life after comprehensive surgical staging of high-risk endometrial cancer – results from the RASHEC trial. Acta Oncologica, 57(12), 1671–1676. https://doi.org/10.1080/0284186X.2018.1521987

Issue

Vol. 57 No. 12 (2018): Acta Oncologica

Section

Articles