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. 2025 Apr:195:50-58.
doi: 10.1016/j.ygyno.2025.02.023. Epub 2025 Mar 9.

Evaluation of physical function and quality of life before and after nonradical surgical therapy for stage IA1 and IA2-IB1 cervical cancer (GOG-0278)

Jeanne Carter  1 , Helen Q Huang  2 , Bradley J Monk  3 , Yong-Beom Kim  4 , Moon-Hong Kim  5 , Ashley Stuckey  6 , Danielle L Vicus  7 , Laura L Holman  8 , Aimee C Fleury  9 , J Matthew Pearson  10 , Nitika Thawani  11 , Mark Shahin  12 , Jayanthi Lea  13 , Sharon E Robertson  14 , David Warshal  15 , Floor J Backes  16 , Colleen Feltmate  17 , Ivy Wilkinson-Ryan  18 , Allan Covens  19
Affiliations

Evaluation of physical function and quality of life before and after nonradical surgical therapy for stage IA1 and IA2-IB1 cervical cancer (GOG-0278)

Jeanne Carter et al. Gynecol Oncol. 2025 Apr.

Abstract

Objective: To examine patient outcomes before and after cone biopsy (CB) or simple hysterectomy (SH) and pelvic lymph node dissection (PLND) for bladder, bowel, and sexual function, quality of life (QOL), cancer worry, reproductive concerns, and lymphedema.

Methods: We stratified women with stage IA1 (lymphovascular space invasion-positive) and IA2-IB1 (≤2 cm) cervical carcinoma by fertility preservation (CB) or none (SH) with PLND. All patients completed study questionnaires at baseline (preoperatively) and postoperatively at 4-6 weeks and 6-, 12-, 18-, and 24-months, consisting of: Functional Assessment Cancer Therapy - Cervical Cancer (FACT-Cx); Female Sexual Functioning Index (FSFI), and 2 Patient-Reported Outcomes Measurement Information System (PROMIS) items; Gynecologic Cancer Lymphedema Questionnaire (GCLQ); Impact of Events Scale (IES); and Reproductive Concerns Scale (RCS).

Results: We enrolled 224 patients from 10/12 to 10/21, with 72 choosing CB and 152 SH. A total of 169 patients (54 CB; 115 SH) were eligible for QOL analysis and completed baseline assessment with at least one follow-up assessment. Postoperatively in both groups, bladder and bowel function slightly decreased but recovered over time, sexual function declined at 6 weeks but improved over time, QOL increased, and cancer worry decreased. As per the GCLQ, 12 patients reported a diagnosis of lymphedema with a GCLQ score change ≥4 (6 CB; 6 SH).

Conclusions: Nonradical surgery for early-stage cervical cancer is associated with excellent QOL and small decreases in physical function (bladder, bowel, sexual) that quickly improve postoperatively to baseline or above. Lymphedema rates were low but present in both groups.

Keywords: Cervical cancer; Nonradical surgery; Physical and sexual function; Quality of life; Reproductive outcomes.

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Conflict of interest statement

Declaration of competing interest The following coauthors have no conflicts of interest to declare: Drs. Jeanne Carter, Bradley Monk, Yong Beom Kim, Moon-Hong Kim, Ashley Stuckey, Laura Holman, Aimee Fleury, J. Matt Pearson, Nitika Thawani, Jayanthi Lea, David Warshal, Ivy Wilkinson-Ryan and Ms. Helen Huang. Dr. Danielle Vicus reports serving on an Advisory Board for GSK. Dr. Mark Shahin reports personally receiving consulting fees from the following: GSK, AZ, Merck, Immunogen/AbbVie. In addition, Dr. Shahin reports receiving honoraria for lectures, presentations, Speakers bureaus for the following: GSK, AZ, Merck, AbbVie/Immunogen, Genmab, Myriad and Caris. Dr. Shahin also served as a Board member for Unite For Her. Dr. Sharon Robertson reports receiving support for travel and lodging for the Annual Guidelines meeting for the NCCN Ovarian Cancer Guidelines Committee meeting. Dr. Floor Backes reports research grants for investigator-initiated studies paid to the institution by the following: Merck, Eisai, ImmunoGen, Clovis, Natera, Tempus, AstraZeneca. Dr. Backes also received personal fees from UptoDate. Additionally, Dr. Backes received personal feels for serving on Advisory Boards for the following: Merck, Clovis, Immunogen, Eisai, AstraZeneca, GlaxoSmithKline, Myriad, BioNTech, Daiichi Sankyo and EMD Serono. She also received personal fees for CME lectures from Clinical Educational Concepts, Clinical Care Options, Medscape/WebMD, Med Learning, I3Health, CMR Institute, Global Learning Initiative/Prova, OncLive, Targeted Oncology, Research to Practice and the GOG Foundation. She also received support to attend meetings from GlaxoSmithKline and BioNTech. Finally, Dr. Backes served in uncompensated positions for the following: Board member for the Society of Gynecologic Oncology, Co-Chair for NRG Oncology Developmental Therapeutics Committee and Co-Chair for the IGCS Education 360. Dr. Colleen Feltmate received payment as an Author for UpToDate and served as a member of the Data Safety Monitoring Board for Avania. Dr. Allan Covens reports grants from GSK-investigator-initiated clinical trial, support for travel from GOG-Foundation, IGCS.

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