Quality of life in long-term cervical cancer survivors compared with healthy women and women with benign gynecological disorders.

OBJECTIVE: The impact of cervical cancer treatment on the quality of life of long-term survivors compared with the general female population is controversial, and no studies have been conducted comparing patients with benign gynecological diseases. The aim of this study was to compare the quality of life of cervical cancer survivors with that of healthy controls. STUDY DESIGN: A case-control study was conducted to compare the quality of life of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a healthy woman check-up (n 46) or for a benign gynecological disorder (symptomatic, n 113; asymptomatic, n 26). To measure quality of life, self-administered questionnaires, such as the Functional Assessment Cancer Therapy-cervix and World Health Organization quality of life-brief version, were employed. Baseline scores were collected when patients first reported, and further evaluations were completed at 0-6, 7-12, 13-24, 25-60, and more than 60 months. For the contrastive analysis hypothesis, we employed R statistical software. RESULTS: Except for the environment domain at 0-6, 7-12, and 13-24 months (51.52 vs. 60.73, p < 0.0001; 52 vs. 60.73, p < 0.0001; 49.81 vs. 60.73, p < 0.0001, respectively), we found no statistically significant differences in the quality of life between cervical cancer survivors and controls. We did find differences in the physical health domain scores at 0-6 months (60.22 vs. 72.42, p = 0.039) and the social relationships domain scores at 13-24 months (54 vs. 71.42, p = 0.017) between cases and asymptomatic controls. CONCLUSION: Except for physical well-being, environment and social relationships, which were substantially better for controls, especially in the asymptomatic, long-term cervical cancer survivorsquality of life did not vary from that of controls.

Development and internal validation of a multivariable prediction model for the quality of life of cervical cancer survivors.

PURPOSE: To elaborate a prediction model for quality of life of cervical cancer survivors. METHODS: We conducted a prospective cohort study on 229 cervical cancer survivors. The quality of life measures included the Functional Assessment Cancer Therapy-Cervix version 4.0 and the World Health Organization Quality of Life-brief version self-administered questionnaires. We imported the data into the statistical software program R and developed a gamma generalized linear model. RESULTS: Our internally validated predictive model for the Functional Assessment Cancer Therapy-Cervix total score was composed of the following predictors: pain, appetite, vaginal bleeding/discharge/odor, and WHOQOL-BREF social relationships domain. The Harrell's concordance index was 0.75. CONCLUSIONS: We developed a solid and internally validated predictive model in cervical cancer survivors based on predictors, such as pain, appetite, vaginal bleeding/odor/discharge, and WHOQOL-BREF social relationships subscale score that contribute significantly to quality of life as targets for potential intervention.

Incidence and univariate models for lymphatic drainage disorders following management for cervical cancer.

AIM: To clarify the incidence of lymphatic drainage disorders (LLD) after treatment for cervical cancer (CC) and to establish univariate models for their occurrence. METHODS: A total of 263 eligible patients with CC were identified between 2010 and 2019. We conducted a case-control study and divided the study population into two subsamples of 12 and 251 CC survivors based on the presence/absence of LLD, respectively. The cumulative incidence was evaluated using the Kaplan-Meier method. Univariate models based on Pearson correlation coefficient were used to evaluate associations between explanatory variables and LLD. RESULTS: The cumulative incidence of LLD began at 3.3% after the 7-month follow-up, reaching a plateau of 21.2% between 130 and 250 months of follow-up. We detected correlation between LLD and number of removed para-aortic lymph nodes (r = -0.39), number of pelvic lymphadenopathies (r = 0.16), pelvic lymphadenectomy (PL) (r = 0.16), age at diagnosis of CC (r = -0.1) and primary surgery (r = 0.1). CONCLUSION: We observed a cumulative incidence of LLD of 21.2%, which is in accord with other retrospective studies. Number of removed para-aortic lymph nodes, number of pelvic lymphadenopathies, PL, age at diagnosis of CC and primary surgery were the most influential clinical factors associated with the occurrence of LLD in CC survivors.

Treatment and Impact of Cervical-Cancer-Related Lymphatic Disorders on Quality of Life and Sexuality Compared with Controls.

Background: Lymphatic disorders are frequent complications related to treatment for cervical cancer (CC). The aims of the study are to evaluate the impact of lymphatic disorders on quality of life (QOL) and sexuality in CC survivors after the completion of oncological treatment and to compare them with controls. Methods and Results: An ambispective cohort study was performed by using the Functional Assessment Cancer Therapy (FACT)-Cervix (Cx) fourth version, the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), and the Female Sexual Function Index (FSFI). Twelve patients affected by lymphatic disorders comprised the study group, 251 comprised the CC control group, and 185 comprised the non-CC control group. Regarding QOL, there were no statistically significant differences between the lymphatic disorder-unaffected and non-CC control groups, except in the WHOQOL-BREF environment domain. A weak positive correlation between lymphatic disorder and FACT-Cx additional concerns (σ = 0.135) was observed. Regarding sexuality, a weak negative correlation was detected between lymphatic disorders and FSFI sexual satisfaction (σ = -0.200) and a weak positive correlation was observed between lymphatic disorders and FSFI dyspareunia (σ = 0.148). We did not observe statistically significant differences in QOL satisfaction between the lymphatic disorder-affected and non-CC control groups. Symptomatic controls reported significantly higher physical health scores than the lymphatic disorder-affected group (p < 0.05). Regarding the psychological domain, the asymptomatic controls obtained significantly higher scores than the lymphatic disorder-affected group (p = 0.003). Conclusions: Lymphatic disorders notably influenced the QOL of CC survivors compared with the non-CC control groups. Lymphatic disorders had a significant negative impact on physical and psychological health. Sexuality was scarcely affected by lymphatic disorders.

Predicting the occurrence of wildfires with binary structured additive regression models.

Wildfires are one of the main environmental problems facing societies today, and in the case of Galicia (north-west Spain), they are the main cause of forest destruction. This paper used binary structured additive regression (STAR) for modelling the occurrence of wildfires in Galicia. Binary STAR models are a recent contribution to the classical logistic regression and binary generalized additive models. Their main advantage lies in their flexibility for modelling non-linear effects, while simultaneously incorporating spatial and temporal variables directly, thereby making it possible to reveal possible relationships among the variables considered. The results showed that the occurrence of wildfires depends on many covariates which display variable behaviour across space and time, and which largely determine the likelihood of ignition of a fire. The joint possibility of working on spatial scales with a resolution of 1 × 1 km cells and mapping predictions in a colour range makes STAR models a useful tool for plotting and predicting wildfire occurrence. Lastly, it will facilitate the development of fire behaviour models, which can be invaluable when it comes to drawing up fire-prevention and firefighting plans.