Abstract

OBJECTIVES
To investigate the occurrence and severity of lymphoedema of the lower extremities (LLE), quality of life (QoL), and urinary and sexual dysfunction in women with vulvar cancer submitted to surgical treatment.
STUDY DESIGN
Twenty-eight patients with vulvar cancer submitted to vulvectomy and inguinofemoral lymphadenectomy and 28 healthy, age-matched women (control group) were evaluated. The occurrence and severity of LLE were determined by Miller's Clinical Evaluation. QoL, urinary function and sexual function were assessed by the EORTC QLQ-C30, SF-ICIQ and FSFI questionnaires, respectively. The differences between groups and correlations were assessed using Student's t-test, Chi-squared test, Mann-Whitney U-test and Spearman's rho test.
RESULTS
The groups were similar in terms of marital status, educational status, menopausal status, hormone therapy and height. The occurrence and severity of LLE were higher in women with vulvar cancer compared with the control group (p<0.001 and p = 0.003, respectively). A significant association was found between the severity of LLE and advanced age (p = 0.04), and the severity of LLE and higher body mass index (BMI; p = 0.04) in patients with vulvar cancer. In the patients with vulvar cancer, there was a significant correlation between the severity of LLE and worse QoL in the following domains: physical, cognitive, emotional, social, fatigue, pain, sleep and financial questions (p < 0.05). There was no difference in urinary function between the two groups (p = 0.113). Age and number of deliveries were the only variables associated with the occurrence of urinary incontinence (p = 0.01). Urinary incontinence was present in women with a mean age of 74.9 ± 4.6 years and a mean of 7.3 ± 1.3 normal deliveries. There was no difference between the groups in terms of the sexual function. Multivariate analysis showed an association between sexual function and age (p = 0.01), and sexual function and being in a stable relationship (p=0.02).
CONCLUSION
Patients submitted to vulvectomy or inguinofemoral lymphadenectomy for vulvar cancer are at higher risk of developing LLE compared with healthy, age-matched women. This has a negative effect on QoL, but does not interfere with urinary or sexual function.

Links

Publisher Full Text

Authors

de Melo Ferreira AP, de Figueiredo EM, Lima RA, Cândido EB, de Castro Monteiro MV, de Figueiredo Franco TM, Traiman P, da Silva-Filho AL

Institution

Department of Obstetrics and Gynaecology, Paulista State University, Botucatu, São Paulo, Brazil.

Source

European journal of obstetrics, gynecology, and reproductive biology 165:1 2012 Nov pg 91-5

MeSH

Adult
Age Factors
Aged
Aged, 80 and over
Body Mass Index
Brazil
Case-Control Studies
Female
Humans
Incidence
Lower Extremity
Lymph Node Excision
Lymphedema
Marital Status
Middle Aged
Parity
Quality of Life
Severity of Illness Index
Sexual Dysfunction, Physiological
Urination Disorders
Vulva
Vulvar Neoplasms

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22795579