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Ann Oncol. 2019 Mar 9. pii: mdz074. doi: 10.1093/annonc/mdz074. [Epub ahead of print]

Long-term fatigue and quality of life among epithelial ovarian cancer survivors: A GINECO case/control VIVROVAIRE I Study.

Author information

1
Department of Oncology, Centre François Baclesse, Caen, France.
2
INSERM, U1086, Caen, France.
3
UMR-S1077, University of Caen Basse-Normandie, Caen, France.
4
Department of Oncology, CHU de Caen, Caen, France.
5
Department of Oncology, CHU Jean Minjoz, Besançon, France.
6
Department of Clinical Research, Centre François Baclesse, Caen, France.
7
Department of Oncology, Institut de Cancérologie de l'Ouest, Site René Gauducheau, Saint Herblain, France.
8
Department of Oncology, Centre Léon Bérard, Lyon, France.
9
Department of Oncology, Institut Régional du Cancer, Montpellier, France.
10
Department of Oncology, Institut Jean Godinot, Reims, France.
11
Department of Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
12
Department of Oncology, Hôpital Cochin, Paris, France.
13
Department of Oncology, Centre Antoine Lacassagne, Nice, France.
14
Department of Oncology, Clinique Mutualiste de l'Estuaire, Saint-Nazaire, France.
15
Department of Oncology, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France.
16
Department of Oncology, Centre d'Oncologie de Gentilly, Nancy, France.
17
Department of Oncology, Institut Sainte Catherine, Avignon, France.
18
Department of Oncology, Centre Catherine de Sienne, Nantes, France.
19
Department of Oncology, Institut du Cancer Courlancy, Reims, France.
20
Department of Oncology, Centre Oscar Lambret, Lille, France.
21
Department of Oncology, Centre Hospitalier de Cholet, Cholet, France.
22
Department of Oncology, CH Pau, Pau, France.
23
Department of Oncology, GHPSO Senlis, Senlis, France.
24
Department of Oncology, Centre hospitalier de Sens, Sens, France.
25
Department of Oncology, Institut de Cancérologie de l'Ouest, Site Paul Papin, Angers, France.
26
Department of Oncology, Hôpitaux Universitaires Cochin Hôtel-Dieu Broca, Paris, France.
27
Department of Oncology, Gustave Roussy, Villejuif, France.
28
Department of Oncology, Institut Bergonié, Bordeaux, France.

Abstract

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.

KEYWORDS:

Epithelial ovarian cancer; cancer treatment; chronic fatigue; long-term survivorship; quality of life

PMID:
30851097
DOI:
10.1093/annonc/mdz074

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