Quality-of-Life Trajectories and Perceived Stress in Women Treated for Uterine Cancer: A Six-Month Prospective Study

Abstract

Background and Objectives: Uterine cancer is the most common gynaecologic malignancy in developed countries, yet the psychosocial sequelae of treatment are incompletely described. This prospective, single-centre study quantified six-month changes in the quality of life (QoL) and perceived stress in women with newly diagnosed uterine cancer and explored clinical moderators of change. Methods: Participants completed four validated self-report questionnaires: the 36-item Short-Form Health Survey (SF-36), the 26-item World Health Organization Quality-of-Life-BREF (WHOQOL-BREF), the 30-item EORTC QLQ-C30 and the 10-item Perceived Stress Scale (PSS-10) before therapy and again six months after surgery ± adjuvant chemoradiation. Subgroup analyses were performed for stage (FIGO I-II vs. III-IV). Results: Mean SF-36 Physical Functioning improved from 58.7 ± 12.1 to 63.1 ± 12.6 (Δ = +4.4 ± 7.3; p = 0.000, d = 0.36). PSS declined from 24.1 ± 5.6 to 20.8 ± 5.4 (Δ = -3.3 ± 5.0; p < 0.001, d = 0.66). The WHOQOL-BREF Physical and Psychological domains rose by 4.4 ± 6.9 and 3.5 ± 7.3 points, respectively (both p < 0.01). EORTC QLQ-C30 Global Health increased 5.1 ± 7.6 points (p < 0.001) with parallel reductions in fatigue (-5.4 ± 9.0) and pain (-4.8 ± 8.6). Advanced-stage patients showed larger reductions in stress (ΔPSS -3.5 ± 2.5 vs. -2.3 ± 2.3; p = 0.036) but similar QoL gains. ΔPSS correlated inversely with ΔWHOQOL Psychological (r = -0.53) and ΔSF-36 Mental Health (r = -0.49) and positively with ΔEORTC Global Health (r = -0.42) (all p < 0.001). Conclusions: Over six months, multimodal uterine cancer treatment was associated with clinically meaningful QoL improvements and moderate stress reduction. Greater stress relief paralleled superior gains in psychological and global health indices, highlighting the importance of integrative survivorship care.

Keywords: EORTC QLQ-C30; SF-36 health survey; psychological; quality of life; stress; uterine neoplasms.

Figure 1

Six-month mean changes in patient-reported outcomes.

Figure 2

Correlation matrix of score changes.