Prospective follow-up of quality of life for participants undergoing risk-reducing salpingo-oophorectomy or ovarian cancer screening in GOG-0199: An NRG Oncology/GOG study

Phuong L. Mai
Helen Q. Huang
Lari B. Wenzel
Paul K. J. Han, MaineHealth Institute for ResearchFollow
Richard P. Moser
Gustavo C. Rodriguez, Division of Gynecologic Oncology, North Shore University Health System; Evanston, IL, 60201, USA. Electronic address: grodriguez@northshore.org.
John Boggess, Division of Gynecologic Oncology, University of North Carolina at Chapel Hill; Raleigh NY 27607, USA. Electronic address: john_boggess@med.unc.edu.
Thomas J. Rutherford, Yale University, Norwalk, CT, 06856, USA. Electronic address: thomas.rutherford@yale.edu.
David E. Cohn, Ohio State University, Columbus Cancer Council; GYN Oncology; Columbus, OH, 43026, USA. Electronic address: david.cohn@osumc.edu.
Noah D. Kauff, Gynecologic Medical Oncology Service, Memorial Sloan-Kettering Cancer Center; Surgery Department; New York, NY, 10065, USA. Electronic address: nkauff@northwell.edu.
Kelly-Anne Phillips, Peter MacCallum Cancer Centre, Division of Cancer Medicine, Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 300 AU, Australia. Electronic address: kelly.phillips@petermac.org.
Kelly Wilkinson, University of Mississippi Medical Center, Dept. of Hematology/Oncology, Jackson, MS, 39216, USA. Electronic address: kjeanes@umc.edu.
Robert M. Wenham, H. Lee Moffitt Cancer Center & Research Institute, Gynecology Oncology Division; Tampa, FL, 33612-9497, USA. Electronic address: robert.wenham@moffitt.org.
Chad Hamilton, Walter Reed Army Medical Center, Bethesda, MD, 20889, USA. Electronic address: chad.a.hamilton.mil@health.mil.
Matthew A. Powell, Washington University School of Medicine, Saint Louis, MO, 63110, USA. Electronic address: mpowell@wustl.edu.
Joan L. Walker, Stephenson Cancer Center, Department of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA. Electronic address: joan-walker@ouhsc.edu.
Mark H. Greene, Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20850-9772, USA. Electronic address: greenem@mail.nih.gov.
Martee L. Hensley, Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, 10065, USA. Electronic address: hensleym@mskcc.org.

Document Type

Article

Publication Date

1-2020

Institution/Department

Obstetrics & Gynecology, Oncology

Journal Title

Gynecologic Oncology

MeSH Headings

Adult; Aged; Cohort Studies; Early Detection of Cancer (methods, psychology); Female; Follow-Up Studies; Humans; Middle Aged; Ovarian Neoplasms (diagnosis, prevention & control, psychology, surgery); Prospective Studies; Quality of Life; Salpingo-oophorectomy (methods, psychology)

Abstract

BACKGROUND: Risk-reducing salpingo-oophorectomy (RRSO) and ovarian cancer screening (OCS) are management options for women at increased risk of ovarian cancer. Long-term effects of these interventions on quality of life (QOL) are not well understood. METHODS: GOG-0199 is a prospective cohort study of women at increased ovarian cancer risk who chose either RRSO or OCS as their risk management intervention. At study entry, 6, 12, 24 and 60 months of follow-up, participants completed the QOL questionnaire, which included the Medical Outcome Study Short Form-36, the Impact of Events Scales, the Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory, the Functional Assessment of Cancer Therapy - Endocrine Subscale, and the Sexual Activity Questionnaire. QOL measures were compared between the RRSO and OCS cohort at baseline and over time. RESULTS: Five-hundred-sixty-two participants in the RRSO cohort and 1,010 in the OCS completed the baseline and at least one follow-up questionnaire. At baseline, participants selecting RRSO reported lower health-related QOL (HRQOL), greater ovarian cancer-related stress, greater anxiety, and more depressive symptomatology, which improved during follow-up, especially for ovarian cancer-related stress. Screening was not found to adversely impact HRQOL. Hormone-related menopausal symptoms worsened and sexual functioning declined during follow-up in both cohorts, but more so among participants who underwent RRSO. CONCLUSIONS: HRQOL improved after surgery among women who chose RRSO and remained stable among participants undergoing screening. The adverse effects of RRSO and screening on short-term and long-term sexual activity and sexual functioning warrant consideration in the decision-making process for high-risk women.

First Page

131

Last Page

139

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