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Personalized comprehensive rehabilitation program after surgical treatment of endometrial cancer: results of a prospective randomized comparative study

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.318

Abstract

Aim: to evaluate effectiveness of a personalized comprehensive rehabilitation program in patients after surgical treatment of endometrial cancer (EC).

Material and Methods. There were enrolled 61 patients of reproductive age (44.46 ± 3.84 years) after radical treatment of endometrioid adenocarcinoma by stratifying subjects into 2 groups: group I – «active» rehabilitation with a comprehensive program of restorative measures (n = 29), group II – «passive» rehabilitation with standard management of the postoperative period in accordance with volume and timeframe determined by clinical recommendations (n = 32). Quality of life (QоL) was determined using the following questionnaires: Functional Assessment of Cancer Therapy for Patients with Endometrial Cancer (FACT-En), Kupperman-Uvarova Modified Menopausal Index (MMI), The Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS). The program was based on four patient visits expected to occur at week 1 as well as 3, 6, 12 months after surgery, respectively.

Results. In was found that 12 months post-surgery MMI in group I was decreased from 40.75 ± 5.69 down to 26.45 ± 4.84 score corresponding to mild postovariectomy syndrome (POES), whereas in group II – from 39.62 ± 5.37 to 36.15 ± 4.06 score estimated as moderate POES. In addition, at this time point patients in group I were noted to virtually fully recover sexual function assessed by FSFI (24.93 ± 2.86 score), whereas in group II it was at markedly lower level (13.39 ± 2.55 score; p < 0.001). According to the HADS, all subjects had level exceeding score of 11 at week 1 post-surgery corresponding to clinically significant anxiety and depression. Moreover, 6- and 12-months post-surgery subjects in group I lacked significant symptoms (score < 7 for each parameter), whereas in group II 12-month follow-up demonstrated subclinical level of anxiety and depression. According to the FACT-En, subjects in group I vs. group II revealed markedly higher QoL on visit 4 reaching 141.31 ± 6.45 and 112.84 ± 6.48 score, respectively.

Conclusion. The «active» personalized comprehensive rehabilitation program proposed here demonstrated high efficacy in EC patients after radical surgery compared to subjects underwent standard management in rehabilitation period. Use of the program during 12 months post-surgery allowed to minimize negative manifestations related to POES, positively impacted psycho-emotional status, significantly improved sexual function as well as QoL. Organizing comprehensive rehabilitation in post-surgical EC patients should be considered as one of high-priority approaches in public healthcare.

About the Authors

L. N. Sandzhieva
Sechenov University
Russian Federation

MD, Postgraduate Student, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

RSCI SPIN-code: 7228-3726

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia



A. G. Solopova
Sechenov University
Russian Federation

D, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 6505479504. Researcher ID: Q-1385-2015

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia



D. V. Blinov
Institute for Preventive and Social Medicine; Lapino Clinical Hospital, MD Medical Group
Russian Federation

MD, PhD, MBA, Head of Medical and Scientific Affairs; Neurologist

Scopus Author ID: 6701744871. Researcher ID: E-8906-2017. RSCI: 9779-8290

4–10 Sadovaya-Triumfalnaya Str., Moscow 127006, Russia

111, 1st Uspenskoe Highway, Lapino, Odintsovo District, Moscow region 143081, Russia



E. A. Son
Sechenov University
Russian Federation

MD, PhD, Associate Professor, Department of Faculty Therapy № 1, Sklifosovsky Institute of Clinical Medicine

Scopus Author ID: 19837664400

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia



V. N. Galkin
City Clinical Oncological Hospital № 1, Moscow Healthcare Department
Russian Federation

MD, Dr Sci Med, Professor, Chief Physician

17/1 Baumanskaya Str., Moscow 105005, Russia



A. B. Alekseev
Sechenov University
Russian Federation

6th year Student, International School "Medicine of the Future"

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991, Russia



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Review

For citations:


Sandzhieva L.N., Solopova A.G., Blinov D.V., Son E.A., Galkin V.N., Alekseev A.B. Personalized comprehensive rehabilitation program after surgical treatment of endometrial cancer: results of a prospective randomized comparative study. Obstetrics, Gynecology and Reproduction. 2022;16(2):143-157. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.318

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