Survivorship research in advanced gynecological cancer: A scoping review of cohort studies

Abstract

Background: Recent calls to action highlight the need to address gaps in our understanding of survivorship for those living with advanced gynecological cancer to support optimal care. To ensure future research fills these knowledge gaps, we need to understand the breadth of existing survivorship research in this patient group, including the outcomes assessed, the populations included and the duration and retention in follow-up.

Methods: We conducted a systematic scoping review searching PubMed, PsychINFO, and CINAHL during the month of November 2022 to identify prospective cohort studies measuring survivorship outcomes among participants with advanced (stage III-IV) gynecological cancer, or in cohorts in which ≥50% of participants had advanced cancer, or which provide results separately for patients with advanced cancer. Articles were screened, and data extracted using a standard form.

Results: We assessed 33 articles from 21 unique studies, which overall included 6023 participants with gynecological cancer. Of these, 45% had cervical cancer, 44% ovarian, 10% endometrial/uterine, and 1% vaginal/vulvar cancer. The most frequently measured survivorship outcome was quality of life. Of the 33 articles, most reported on participant age (n = 31), but relatively few reported on comorbidities (n = 10), physical status (n = 6), ethnic background (n = 4), the country of birth (n = 2), or the area of participant residence (n = 2). None included details on indigenous status. Recruitment proportions ranged from 48% to 100%. Retention proportions ranged from 15% to 97%.

Conclusion: Our findings highlight gaps in survivorship research for advanced gynecological cancers and emphasize the need for future studies to include and describe the experiences of diverse and underrepresented groups.

Keywords: advanced cancer; disparity; gynecological cancer; survivorship; systematic review.

FIGURE 1

PRISMA flowchart.

FIGURE 2

Keyword co‐occurrence network visualization.

FIGURE 3

Forest plot for the recruitment proportions of included studies. Sorted alphabetically by cancer site and by proportion of advanced stage (lowest to highest). CI, confidence interval.

FIGURE 4

Forest plot for the retention proportions at the end of follow‐up for survivorship outcomes of included studies. Sorted alphabetically by cancer site and by duration of follow‐up (lowest to highest). CI, confidence interval.