Long-term fatigue and quality of life among epithelial ovarian cancer survivors: A GINECO case/control VIVROVAIRE I Study
Menée en France à partir de données portant sur 318 patientes ayant survécu à un cancer épithélial de l'ovaire et sur 318 témoins, cette étude analyse la fatigue, les symptômes psychiques et physiques, et la qualité de vie plus de 3 ans après la fin des traitements de première ligne (durée moyenne de suivi : 6 ans)
Background : Few data are available on long-term fatigue (LTF) and quality-of-life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free ≥3 years after first-line treatment and age-matched healthy women. Patients and Methods : EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regression were conducted to analyze SLTF and its influencing factors in EOCS. Results : 318 EOCS and 318 controls were included. EOCS were 63-year old on average, with FIGO stage I/II (50%), III/IV (48%); and 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 vs 45, p<0.0001), lower functional well-being scores (18 vs 20, p=0.0002), poorer FACT-O scores (31 vs 34 p<0.0001), and poorer FACT-Ntx scores (35 vs 39, p<0.0001). They also reported more SLTF (26% vs 13%, p=0.0004), poorer sleep quality (63% vs 47%, p=0.0003), and more depression (22% vs 13%, p=0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (p < 0.01). Conclusion : Compared to controls, EOCS presented similar QoL but persistent long-term fatigue, EOC-related symptoms, neurotoxicity, depression and sleep disturbance. Depression, neuropathy and sleep disturbance are the main conditions associated with severe LTF.
Annals of Oncology 2019