Jorge Cea García

A risk nomogram for assessing complications in patients undergoing surgical procedures for cervical cancer. Does baseline quality of life play a role?

AbstractObjectiveSurgery for cervical cancer is a known risk factor for hospital readmission, often due to urological, lymphovascular, or neurological complications. While comorbidities are commonly used to assess surgical risk, patient‐reported measures like baseline quality of life (QoL) may also help predict complications. This study aimed to estimate how often surgical complications occur and what factors predict them, with a focus on baseline QoL.MethodsWe conducted a prospective observational study of 100 cervical cancer patients who had surgery at a tertiary hospital between January 2010 and January 2019. A binary logistic regression model was used to predict surgical complications. Baseline QoL was measured with the Functional Assessment Cancer Therapy‐cervix questionnaire. Data were analyzed using R software.ResultsSurgical complications occurred in 54% of patients, most of them after surgery. There was no significant difference in QoL scores between patients with and without complications (p = 0.753). The prediction model showed good calibration (Hosmer–Lemeshow p = 0.999), no multicollinearity (variance inflation factor = 1.01), and moderate accuracy (C‐index = 0.67). A history of cesarean section and pelvic lymphadenectomy was significant predictors.ConclusionsSurgical complications were common in this group. Cesarean section history and pelvic lymphadenectomy were linked to a higher risk. However, baseline QoL did not predict complications. Further research is needed to test this model in other patient groups.

Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders

To compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. From January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26). We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. Cervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively). Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%). Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). Cervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.

Development and internal validation of a multivariable prediction model for the quality of life of cervical cancer survivors

AbstractPurposeTo elaborate a prediction model for quality of life of cervical cancer survivors.MethodsWe conducted a prospective cohort study on 229 cervical cancer survivors. The quality of life measures included the Functional Assessment Cancer Therapy‐Cervix version 4.0 and the World Health Organization Quality of Life‐brief version self‐administered questionnaires. We imported the data into the statistical software program R and developed a gamma generalized linear model.ResultsOur internally validated predictive model for the Functional Assessment Cancer Therapy‐Cervix total score was composed of the following predictors: pain, appetite, vaginal bleeding/discharge/odor, and WHOQOL‐BREF social relationships domain. The Harrell's concordance index was 0.75.ConclusionsWe developed a solid and internally validated predictive model in cervical cancer survivors based on predictors, such as pain, appetite, vaginal bleeding/odor/discharge, and WHOQOL‐BREF social relationships subscale score that contribute significantly to quality of life as targets for potential intervention.