THE RESULTS OF LIFE QUALITY ASSESSMENT IN PATIENTS WITH PRIMARY OVARIAN CANCER DURING TREATMENT: EFFECT OF DIFFERENT TACTICS AND HIPEC.

Abstract

Introduction: Ovarian cancer ranks first among gynaecological cancers in terms of mortality, mainly due to late detection and high recurrence rates. The standard treatment for late stages remains cytoreductive surgery combined with systemic chemotherapy. However, survival and quality of life for patients with the traditional approach remain unsatisfactory.

Aim: The aim of the study was to analyse the quality of life of patients with primary advanced ovarian cancer depending on the type of treatment tactics before the start of specialized treatment, after cytoreductive surgery in the early and late postoperative periods, during chemotherapy and after the end of specialized treatment.

Materials and methods: A comparative analysis of the results of clinical examination and treatment of 74 patients with primary serous adenocarcinoma of the ovary stages III-IV (FIGO 2015) was performed: Group IA - patients with primary ovarian cancer who underwent primary cytoreductive surgery (PDS) + adjuvant chemotherapy (ACT) - 43 patients; Group IB - patients with primary ovarian cancer who underwent neoadjuvant chemotherapy (NACT) + interval cytoreductive surgery (IDS)+adjuvant chemotherapy - 16 patients; IC group - patients with primary ovarian cancer who underwent primary cytoreductive surgery (PDS) + hyperthermic intraperitoneal chemotherapy (HIPEC) + adjuvant chemotherapy (ACT) - 15 patients.

Results and discussion: At baseline (before the start of special treatment), the mean physical health (PH) score was (47.4±9.4) in the IA group, (46.9±10.3) in the IB group, and (47.2±9.8) in the IC group. The mean psychological health (MH) at baseline was (49.7±11.2) in the IA group, (41.1±10.7) in the IB group, and (43.9±10.9) in the IC group. There was no statistically significant difference in PH and MH indicators among all groups with primary ovarian cancer before the start of special treatment (p>0.05). In the early postoperative period, the mean PH value was (36.1±9.7) in the IA group, (36.0±7.8) in the IB group, and (32.6±8.8) in the IC group (t=1.231; p=0.224); The mean MH was (38.9±9.5), (39.8±8.6) and (39.2±10.1), respectively. In the late postoperative period, the mean PH value was (41.1±9.3) in the IA group, (41.1±10.2) in the IB group, and (41.9±10.4) in the IC group; The average MH value was (39.0±9.2), (38.7±9.7) and (38.0±7.6), respectively.

Conclusions: According to the authors, patients with primary ovarian cancer in the early postoperative period showed a marked decrease in physical functioning, pain intensity, general well-being, and role functioning due to their physical condition. Subsequently, there was a tendency towards a gradual increase in physical health indicators in all groups of patients with primary ovarian cancer in the late postoperative period and after adjuvant chemotherapy. At the same time, there was a moderate decrease in the scores of the scales of life activity, role functioning due to emotional state, social functioning and mental health during special treatment and partial recovery of these scores after the end of special treatment. Hyperthermic intraperitoneal chemoperfusion was accompanied by a decrease in physical health scales in patients, most significantly in the early postoperative period. When assessing the quality of life of patients with primary ovarian cancer using the SF-36 questionnaire, the results indicate no statistically significant negative effect of hyperthermic intraperitoneal chemoperfusion at all stages of treatment.