Restoration of female sexual function in the rehabilitation program after surgical treatment for endometrial cancer

DOI: https://doi.org/10.29296/25877305-2022-10-12
Issue: 
10
Year: 
2022

L. Sandzhieva(1), D. Blinov, Candidate of Medical Sciences(2–4), Professor
A. Solopova(1), MD, Professor E. Achkasov(1), MD; Professor V. Galkin(5), MD;
D. Korabelnikov(4), Candidate of Medical Sciences; D. Petrenko1
1-I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
2-Institute of Preventive and Social Medicine, Moscow
3-Lapino Clinical Hospital, Village of Lapino, Moscow Region
4-F.P. Gaaz Moscow Sociomedical Institute, Moscow
5-City Clinical Oncology Hospital One, Moscow Healthcare Department

Objective. To evaluate the effectiveness of the developed comprehensive personalized rehabilitation program in restoring sexual function in female patients after radical treatment for endometrial cancer (EC). Subjects and methods. The investigation involved 61 reproductive-aged patients with histologically verified endometrioid carcinoma after radical surgery. The women were randomized into 2 groups: 1) 29 patients treated with an active rehabilitation through a comprehensive restorative program; 2) 32 patients treated with a passive rehabilitation, whose management corresponded to clinical recommendations. Follow-ups were performed at 1 week and 3, 6, and 12 months after surgery. Each visit included clinical examination and assessment of sexual function, by using the FSFI questionnaire. Results. Statistically significant differences between the groups were obtained after 6 and 12 months. At the end of the study, the total FSFI score showed an almost complete recovery of sexual function in the active rehabilitation group (a total FSFI score of 24.93±2.86), unlike the comparison group (a total FSFI score of 13.39±2.55; p < 0.001). Conclusion. Comprehensive personalized rehabilitation mitigates the consequences of radical surgery in patients with EC, contributing to the restoration of sexual function within 1 year after surgery.

Keywords: 
oncology
endometrial cancer
sexual dysfunction
quality of life
rehabilitation



References: 
  1. Sung H. et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71 (3): 209–49. DOI: 10.3322/caac.21660
  2. Fernandez-Montoli M.E., Sabadell J., Contreras-Perez N.A. Fertility-Sparing Treatment for Atypical Endometrial Hyperplasia and Endometrial Cancer: A Cochrane Systematic Review Protocol. Adv Ther. 2021; 38 (5): 2717–31. DOI: 10.1007/s12325-021-01693-y
  3. Kaprin A.D., Starinskii V.V., Shakhzadova A.O. Zlokachestvennye novoobrazovaniya v Rossii v 2020 godu (zabolevaemost' i smertnost'). M.: MNIOI im. P.A. Gertsena – filial FGBU «NMITs radiologii» Minzdrava Rossii, 2021; р. 252 (in Russ.).
  4. Solopova A.G., Blinov D.V., Begovich E. et al. Neurological disorders after hysterectomy: from pathogenesis to clinical manifestations. Epilepsy and paroxysmal conditions. 2022; 14 (1): 54–64 (in Russ.). DOI: 10.17749/2077-8333/epi.par.con.2022.115
  5. Vlasina A.V., Idrisova L.E., Solopova A.G. et al. Rehabilitation of oncogynecological patients after antitumor therapy: ways of solution. Obstetrics, Gynecology and Reproduction. 2020; 14 (1): 44–55 (in Russ.). DOI: 10.17749/2313-7347.2020.14.1.44-55
  6. Son J., Carr C., Yao M. et al. Endometrial cancer in young women: prognostic factors and treatment outcomes in women aged ≤40 years. Int J Gynecol Cancer. 2020; 30 (5): 631–9. DOI: 10.1136/ijgc-2019-001105
  7. Natavio K.M.A., Billod J.A. Sexual dysfunction among patients with endometrial cancer at a tertiary training public institution: A cross-sectional study. Philippine J Obstet Gynecol. 2021; 45 (6): 608–12. DOI: 10.1097/IGC.0000000000000905
  8. Karataşli V., Can B., Çakir I. et al. Life quality of endometrioid endometrial cancer survivors: a cross-sectional study. J Obstet Gynaecol. 2021; 41 (4): 621–5. DOI: 10.1080/01443615.2020.1787969
  9. Rizzuto I., Oehler M.K., Lalondrelle S. Sexual and Psychosexual Consequences of Treatment for Gynaecological Cancers. Clin Oncol. 2021; 33 (9): 602–7. DOI: 10.1016/j.clon.2021.07.003
  10. Smith S.R., Zheng J.Y., Silver J. et al. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil. 2018; 42 (1): 8–13. DOI: 10.1080/09638288.2018.1514662
  11. Rak tela matki i sarkomy matki. Klinicheskie rekomendatsii. Minzdrav Rossii. 2020. Elektronnyi resurs (in Russ.). URL: https://cr.minzdrav.gov.ru/recomend/460_3
  12. Vlasina A.Yu., Solopova A.G., Son E.A. et al. Psycho-emotional well-being and sexual function of patients with borderline ovarian tumors. Obstetrics, Gynecology and Reproduction. 2020; 14 (5): 551–67 (in Russ.). DOI: 10.17749/2313-7347/ob.gyn.rep.2020.147
  13. Wiegel M., Meston C., Rosen R. The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005; 31 (1): 1–20. DOI: 10.1080/00926230590475206
  14. Smith T., Kingsberg S.A., Faubion S. Sexual dysfunction in female cancer survivors: Addressing the problems and the remedies. Maturitas. 2022; 165: 52–7. DOI: 10.1016/j.maturitas.2022.07.010
  15. Hosseini S.E., Ilkhani M., Rohani C. et al. Prevalence of sexual dysfunction in women with cancer: A systematic review and meta-analysis. Int J Reprod BioMed. 2022; 20: 1–12. DOI: 10.18502/ijrm.v20i1.10
  16. Gao J., Tian J., Lv Y. et al. Leptin induces functional activation of cyclooxygenase-2 through JAK2/STAT3, MAPK/ERK, and PI3K/AKT pathways in human endometrial cancer cells. Cancer Sci. 2009; 100 (3): 389–95. DOI: 10.1111/j.1349-7006.2008.01053.x
  17. Onujiogu N., Johnson, T., Seo. et al. Survivors of endometrial cancer: who is at risk for sexual dysfunction? Gynecol Oncol. 2011; 123 (2): 356–9. DOI: 10.1016/j.ygyno.2011.07.035
  18. Blinov D.V., Solopova A.G., Plutnitskiy A.N. et al. Strengthening health care to provide rehabilitation services for women with cancer diseases of the reproductive system. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022; 15 (1): 119–30 (in Russ.). DOI: 10.17749/2070-4909/farmakoekonomika.2022.132
  19. Solopova A.G., Blinov D.V., Demyanov S.V. et al. Epigenetic aspects in rehabilitation of female cancer patients. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2022; 15 (2): 294–303 (in Russ.). DOI: 10.17749/2070-4909/farmakoekonomika.2022.141