1
|
Woopen H, Keller M, Zocholl D, Mittelstadt S, Barretina-Ginesta MP, Heinzelmann-Schwarz V, Lafleur J, Kocián R, Baum J, Krabisch P, Achimas-Cadariu P, Vardar MA, Vergote I, Nasser S, Link T, Gil-Martin M, Zwimpfer TA, Leitner K, Jedryka M, Boxler T, Braicu EI, Sehouli J. Side Effects from Cancer Therapies and Perspective of 1044 Long-Term Ovarian Cancer Survivors-Results of Expression VI-Carolin Meets HANNA-Holistic Analysis of Long-Term Survival with Ovarian Cancer: The International NOGGO, ENGOT, and GCIG Survey. Cancers (Basel) 2023; 15:5428. [PMID: 38001688 PMCID: PMC10670049 DOI: 10.3390/cancers15225428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this survey was to increase the knowledge on the characteristics and health concerns of long-term survivors (LTS; survival > 5 years) after ovarian cancer in order to tailor follow-up care. This international survey was initiated by the NOGGO and was made available to members of ENGOT and GCIG. The survey is anonymous and consists of 68 questions regarding sociodemographic, medical (cancer) history, health concerns including distress, long-term side effects, and lifestyle. For this analysis, 1044 LTS from 14 countries were recruited. In total, 58% were diagnosed with FIGO stage III/IV ovarian cancer and 43.4% developed recurrent disease, while 26.0% were receiving cancer treatment at the time of filling in the survey. LTS who survived 5-10 years self-estimated their health status as being significantly worse than LTS who survived more than 10 years (p = 0.034), whereas distress also remained high 10 years after cancer diagnosis. Almost half of the cohort (46.1%) reported still having symptoms, which were mainly lymphedema (37.7%), fatigue (23.9%), pain (21.6%), polyneuropathy (16.9%), gastrointestinal problems (16.6%), and memory problems (15.5%). Almost all patients (94.2%) regularly received follow-up care. Specialized survivorship care with a focus on long-term side effects, lifestyle, and prevention should be offered beyond the typical five years of follow-up care.
Collapse
Affiliation(s)
- Hannah Woopen
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Maren Keller
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Dario Zocholl
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Suzana Mittelstadt
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Women’s Health, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Maria-Pilar Barretina-Ginesta
- Institut Català d’Oncologia, Medical Oncology Department, 17007 Girona, Spain
- Precision Oncology Group, Institut d’Investigació Biomèdica de Girona, 17007 Girona, Spain
- Medical Sciences Department, Universitat de Girona, 17003 Girona, Spain
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
| | - Viola Heinzelmann-Schwarz
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Judith Lafleur
- Department of Gynecology and Obstetrics, Ordensklinikum Barmherzige Schwestern Linz, 4020 Linz, Austria
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
| | - Roman Kocián
- Department of Gynaecology, Obstetrics and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, 12 108 Prague, Czech Republic
- General University Hospital in Prague, 12 808 Prague, Czech Republic
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
| | - Joanna Baum
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Petra Krabisch
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynaecology and Obstetrics, Klinikum Chemnitz, 09116 Chemnitz, Germany
| | - Patriciu Achimas-Cadariu
- Institute of Oncology Prof. Dr. I. Chiricuta Cluj-Napoca, University of Medicine and Pharmacy Iuliu Hatieganu, 400015 Cluj-Napoca, Romania
| | - Mehmet Ali Vardar
- Department of Gynecologic Oncology, Cukurova University, 01250 Adana, Turkey
- Turkish Society of Gynecologic Oncology (TRSGO), Ovecler, 06450 Ankara, Turkey
| | - Ignace Vergote
- Division of Gynaecological Oncology, Leuven Cancer Institute, University Hospitals Leuven, 3000 Leuven, Belgium
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG), 3000 Leuven, Belgium
| | - Sara Nasser
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- Pan-Arabian Research Society of Gynecological Oncology (PARSGO), 13353 Berlin, Germany
| | - Theresa Link
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
- Department of Gynecology and Obstetrics, Technische Universität Dresden, 01307 Dresden, Germany
| | - Marta Gil-Martin
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), 28003 Madrid, Spain
- Catalan Institute of Oncology—IDIBELL, L’Hospitalet-Barcelona, 08908 Barcelona, Spain
| | - Tibor A. Zwimpfer
- Department of Gynecology and Gynecologic Oncology, University Hospital of Basel, 4056 Basel, Switzerland
- Swiss GO Trial Group (Swiss-GO), 4031 Basel, Switzerland
| | - Katharina Leitner
- Arbeitsgemeinschaft Gynaekologische Onkologie Austria (AGO Austria), 6020 Innsbruck, Austria
- Department of Obstetrics and Gynecology, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Marcin Jedryka
- Central and Eastern European Gynecologic Oncology Group (CEEGOG), 128 51 Prague, Czech Republic
- Gynecological Oncology Department, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Oncological Gynecology Department, Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | | | - Elena Ioana Braicu
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological Surgery, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
- North-Eastern German Society for Gynecological Oncology (NOGGO), 13359 Berlin, Germany
| |
Collapse
|
2
|
Xie N, Lin J, Liu L, Deng S, Yu H, Sun Y. Nomograms constructed for predicting diagnosis and prognosis in cervical cancer patients with second primary malignancies: a SEER database analysis. J Cancer Res Clin Oncol 2023; 149:13201-13210. [PMID: 37479758 DOI: 10.1007/s00432-023-05192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Cervical cancer (CC) patients are more likely to develop second primary malignancies (SPMs) than general population. With the advancement in cancer therapy, CC patients are achieving long-term survival, leading SPMs to our attention. Our study aims to establish diagnostic and prognostic nomograms for CC patients with second primary malignancies (CCSPMs) to help make personalized follow-up plans and treatments. METHODS Data of CCSPMs between 2000 and 2019 was extracted from SEER. The proportions and the median interval time of CCSPM onset were calculated. 11 related clinical characteristics, including age, race, marital status, grade, FIGO stage, radiotherapy, chemotherapy, and surgery, were further explore. Logistic and Cox regressions were employed to predict risk factors for CCSPMs diagnosis. Finally, two nomograms were developed to predict the probability occurrence and prognosis of CCSPMs, respectively. RESULTS For diagnostic nomogram construction, 59,178 CC patients were randomly divided into training (n = 41,426) and validation cohorts (n = 17,752). For prognostic nomogram construction, 3527 CCSPMs patients were randomly divided into training (n = 2469) and validation cohorts (n = 1058). The diagnostic nomogram consisting of above 11 independent risk factors (all P < 0.05), had high accuracy (AUCtraining = 0.851 and AUCvalidating = 0.845). The prognostic nomogram integrated with eight independent prognostic factors such as treatments, FIGO stage and TNM stage performed well in predicting 5-year OS (AUCtraining = 0.835 and AUCvalidating = 0.837). CONCLUSION Our diagnostic and prognostic nomograms could facilitate clinicians to quantify individual SPMs risk and survival probabilities and optimize the surveillance recommendations and personalized clinical decision-making.
Collapse
Affiliation(s)
- Ning Xie
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Jie Lin
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Linying Liu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Sufang Deng
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Haijuan Yu
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China
| | - Yang Sun
- Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
| |
Collapse
|
3
|
Brummel B, van Heumen C, Smits A, van den Berg M, Ezendam NPM, Pijnenborg JMA, de van der Schueren MAE, Wilkinson SA, van der Meij BS. Barriers to and facilitators of a healthy lifestyle for patients with gynecological cancer: a systematic review of qualitative and quantitative research with healthcare providers and patients. Maturitas 2023; 177:107801. [PMID: 37541112 DOI: 10.1016/j.maturitas.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/06/2023]
Abstract
The prevalence of an unhealthy lifestyle among patients with gynecological cancer is high and associated with increased risk of all-cause mortality. Although lifestyle changes have the potential to improve outcomes, lifestyle counseling is not routinely integrated into standard care. This review explores research on the barriers to and facilitators of both the promotion of healthy lifestyles by healthcare providers (HCPs) and healthy lifestyle changes by patients with gynecological cancer. The Theoretical Domains Framework (TDF) was used to deductively code the identified factors for a comprehensive understanding of the barriers and facilitators. A search across five databases yielded a total of 12,687 unique studies, of which 43 were included in the review. Of these 43, 39 included gynecological cancer patients and only 6 included HCPs. Among the barriers identified for HCPs, most studies evaluated barriers regarding weight loss counseling. Limited knowledge, reluctance to address weight loss, skepticism about the benefits, and workload concerns were commonly reported barriers for HCPs. HCPs will benefit from education and training in lifestyle counseling, including effective communication skills like motivational interviewing. Gynecological cancer patients lacked tools, support, knowledge, and faced mental health issues, environmental constraints, and physical limitations. The review emphasizes the importance of addressing these barriers and utilizing identified facilitators, such as social support, to promote and support healthy lifestyle behaviors on the part of patients and their promotion by HCPs. Future research should focus not only on patients but also on supporting HCPs and implementing necessary changes in current practices.
Collapse
Affiliation(s)
- Bo Brummel
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands
| | - Cindy van Heumen
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands
| | - Anke Smits
- Department of Obstetrics & Gynecology, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Manon van den Berg
- Department of Gastroenterology and Hepatology- Dietetics, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Nicole P M Ezendam
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands; Netherlands Comprehensive Cancer Organisation, 5612 HZ Eindhoven, the Netherlands
| | | | - Marian A E de van der Schueren
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands
| | - Shelley A Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospital, South Brisbane 4101, Australia; Lifestyle Maternity, Brisbane, QLD 4069, Australia
| | - Barbara S van der Meij
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, QLD 4226, Australia.
| |
Collapse
|
4
|
Quantification of Women Who Could Benefit from Hormone Therapy after Endometrial Cancer Treatment: An Analysis of SEER Data. Curr Oncol 2022; 29:9215-9223. [PMID: 36547135 PMCID: PMC9777495 DOI: 10.3390/curroncol29120721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Our primary aim was to estimate the magnitude of stage I endometrial cancer (EC) survivors that could benefit from hormonal therapy (HT). Our secondary aims were to assess EC incidence in women below 50 and below 60 over the years, and analyze the overall survival and any influencing factors. We analyzed the endometrioid EC data from the Surveillance, Epidemiology, and End Results (SEER) program according to women's age, tumor stage, and grade. We analyzed the proportions of EC survivors below 50 and below 60 years of age and stratified those age groups by race. For age distribution and survival analysis SEER, 18 registries' research data (2000-2018) were analyzed. We analyzed the SEER 12 registries' research data (1992-2019) for incidence time trends. Our investigation found a 14% and 40% cumulative prevalence of stage I EC that occurs in women below 50 or 60 years, respectively. EC's prevalence has progressively risen in recent decades, but cancer-specific mortality remains low. The increasing number of women affected by EC in premenopause or early postmenopause face an 18 years-survival rate of 96.86% and 95.73%, respectively. A significant proportion of low-grade EC survivors can potentially benefit from HT treatment, and this requires awareness of other aspects of their health or quality of life, in addition to cancer treatments.
Collapse
|