Oxley, Samuel;
Xiong, Ran;
Wei, Xia;
Kalra, Ashwin;
Sideris, Michail;
Legood, Rosa;
Manchanda, Ranjit;
(2022)
Quality of Life after Risk-Reducing Hysterectomy for Endometrial Cancer Prevention: A Systematic Review.
Cancers
, 14
(23)
, Article 5832. 10.3390/cancers14235832.
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Abstract
BACKGROUND: Risk-reducing hysterectomy (RRH) is the gold-standard prevention for endometrial cancer (EC). Knowledge of the impact on quality-of-life (QoL) is crucial for decision-making. This systematic review aims to summarise the evidence. Methods: We searched major databases until July 2022 (CRD42022347631). Given the paucity of data on RRH, we also included hysterectomy as treatment for benign disease. We used validated quality-assessment tools, and performed qualitative synthesis of QoL outcomes. RESULTS: Four studies (64 patients) reported on RRH, 25 studies (1268 patients) on hysterectomy as treatment for uterine bleeding. There was moderate risk-of-bias in many studies. Following RRH, three qualitative studies found substantially lowered cancer-worry, with no decision-regret. Oophorectomy (for ovarian cancer prevention) severely impaired menopause-specific QoL and sexual-function, particularly without hormone-replacement. Quantitative studies supported these results, finding low distress and generally high satisfaction. Hysterectomy as treatment of bleeding improved QoL, resulted in high satisfaction, and no change or improvements in sexual and urinary function, although small numbers reported worsening. CONCLUSIONS: There is very limited evidence on QoL after RRH. Whilst there are benefits, most adverse consequences arise from oophorectomy. Benign hysterectomy allows for some limited comparison; however, more research is needed for outcomes in the population of women at increased EC-risk.
| Type: | Article |
|---|---|
| Title: | Quality of Life after Risk-Reducing Hysterectomy for Endometrial Cancer Prevention: A Systematic Review |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/cancers14235832 |
| Publisher version: | https://doi.org/10.3390/cancers14235832 |
| Language: | English |
| Additional information: | © 2022 by the Authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
| Keywords: | endometrial cancer prevention; risk reducing hysterectomy; hysterectomy; quality of life; satisfaction; decision regret; menopause; Lynch syndrome |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10160896 |
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