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Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2023

01-12-2023 | Cervical Cancer | Research

Vaginal morbidity, sexual functioning, and health-related quality of life in cervical cancer survivors: a cross-sectional multicenter study (VAMOS)

Authors: Eline Naert, Alexander Decruyenaere, Renée Bultijnck, Emiel A. De Jaeghere, Marjolein R. P. Orije, Rawand Salihi, Hans Verstraelen, Philippe Tummers, Hannelore G. Denys, Katrien Vandecasteele

Published in: Supportive Care in Cancer | Issue 12/2023

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Abstract

Purpose

To compare sexual/vaginal functioning between early cervical cancer (ECC) and locally advanced cervical cancer (LACC) survivors.

Methods

VAMOS was a multicenter, cross-sectional, questionnaire, noninferiority study including ECC patients treated with surgery and, if clinically indicated, adjuvant (chemo)radiotherapy and LACC patients treated with neoadjuvant (chemo)radiotherapy followed by surgery. Patient-reported outcomes (PROs) were assessed using the EORTC QLQ-C30, EORTC QLQ-CX24, and Female Sexual Functioning Index (FSFI) questionnaires. Clinical reported outcomes (ClinROs) consisted of vaginal morbidity scored according to the CTCAE v4.0 scoring system.

Results

One hundred forty-three patients were included. Compared to ECC patients (n = 97), LACC patients (n = 46) were significantly less sexually active in the 4 weeks prior to completion of the questionnaires (65% vs. 41%; p = .005). The primary endpoint was not met: LACC patients reported a higher mean score (more problems) for sexual/vaginal functioning than ECC patients, with a non-clinically relevant mean difference of 6.38 ([95% CI: − 6.41, 19.17]; p = .570 for noninferiority). Regarding the secondary endpoints, the prevalence of sexual dysfunction between the two groups did not differ significantly (p = 0.124). Compared to ECC patients, LACC patients did not have significantly more vaginal morbidity (adjusted odds ratio [OR] 1.51 [95% CI: 0.22, 10.29]; p = .674). Moreover, there was poor agreement between any vaginal morbidity and sexual dysfunction (Cohen’s kappa of 0.17).

Conclusion

Compared to ECC survivors, LACC survivors were significantly less sexually active and reported equivalent or worse sexual/vaginal functioning, although the proportion of patients with sexual dysfunction was similar. Clinical assessment of vaginal morbidity was poorly correlated with sexual dysfunction.
Appendix
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Metadata
Title
Vaginal morbidity, sexual functioning, and health-related quality of life in cervical cancer survivors: a cross-sectional multicenter study (VAMOS)
Authors
Eline Naert
Alexander Decruyenaere
Renée Bultijnck
Emiel A. De Jaeghere
Marjolein R. P. Orije
Rawand Salihi
Hans Verstraelen
Philippe Tummers
Hannelore G. Denys
Katrien Vandecasteele
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 12/2023
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-023-08155-x

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