Quality of life after radical trachelectomy for early-stage cervical cancer: A 5-year prospective evaluation

Objectives To longitudinally assess quality of life (QOL) in women undergoing radical trachelectomy for early-stage cervical cancer. Methods We prospectively enrolled patients with stage IA1-IB1 cervical cancer prior to undergoing radical trachelectomy to complete validated QOL instruments. These instruments included the General Health-Related QOL (SF-12), Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision scale (SWD). Instruments were filled out at baseline, postoperatively at 6 weeks, 6 months, 1 year, and annually thereafter for 4 years. Results Thirty-nine patients enrolled in the study, and 32 patients were evaluable. The scores for FSFI-arousal (p = 0.0002), lubrication (p < 0.0001), orgasm (p = 0.006), pain (p = 0.01), satisfaction (p = 0.03) and total score (p = 0.004) showed a significant decline at 6 weeks then returned to baseline levels by 6 months. The scores for FACT-Cx functional well-being (p = 0.02) and physical well-being (p < 0.0001), SF-12 bodily pain (p < 0.0001), physical functioning (p < 0.0001), role physical (p < 0.0001), role emotional (p = 0.03), social functioning (p = 0.002), and MDASI total (p = 0.04) showed significantly worsened symptoms at 6 weeks then returned to baseline by 6 months. The scores for FACT-Cx emotional well-being showed significant worsening of symptoms that persisted at 6-weeks (p = 0.004), 6 months (p = 0.007), 1 year (p = 0.001), 2 years (p = 0.002), and 4 years (p = 0.03). There was no difference in SWD. Conclusions Several quality of life assessments decline immediately postoperatively after radical trachelectomy, however, return to baseline thereafter. The long-term emotional impact of this surgery highlights a need for perioperative counseling in these patients.