Changes in Quality of Life, Depression, and Menopausal Symptoms After Surgical Menopause and the Efficacy of Hormone Replacement Therapy in Gynecological Cancer Survivors: A One-Year Prospective Longitudinal Study
Abstract
1. Introduction
2. Material and Methods
2.1. Study Population
2.2. Background and Purpose
2.3. Questionnaires
2.4. Details of the Questionnaires
2.4.1. QOL and Menopausal Symptom Assessment by FACT-G and ESS-19
2.4.2. Assessment of Emotional Distress by CES-D
2.5. Statistical Analysis
3. Results
3.1. Changes in QOL, Emotional Distress, and Menopausal Symptoms
3.2. Examination of the Efficacy of HRT in GCSs After Surgical Menopause
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | SH (N = 47) | SM (N = 54) | NM (N = 54) | p-Value |
---|---|---|---|---|
Age (years) | ||||
Median (range) | 41 (27–53) | 48 (28–56) | 59 (50–73) | <0.001 * |
<40 | 19 (40.4%) | 5 (9.3%) | 0 | |
40–49 | 26 (55.3%) | 27 (50.0%) | 0 | |
50–59 | 2 (4.3%) | 22 (40.7%) | 23 (42.6%) | |
≥60 | 0 | 0 | 31 (57.4%) | |
BMI (kg/m2) | ||||
Median (range) | 23.2 (16.5–48.1) | 25.3 (16.8–51.3) | 23.7 (17.2–38.8) | 0.240 |
<25 | 32 (68.1%) | 26 (48.1%) | 31 (57.4%) | |
25–30 | 7 (14.9%) | 17 (31.5%) | 12 (22.2%) | |
>30 | 8 (17.0%) | 11 (20.4%) | 11 (20.4%) | |
Cancer type and FIGO stage | 0.006 * | |||
Endometrial cancer | 21 (44.7%) | 40 (74.1%) | 40 (74.1%) | |
0:1, I:17, II:1, III:1, IV:1 | 0:3, I:28, II:4, III 5, IV:0 | 0:0, I:33, II:3, III:2, IV:2 | ||
Cervical cancer | 22 (46.8%) | 8 (14.8%) | 8 (14.8%) | |
I:13, II:7, III:2, IV:0 | I:4, II:4, III:0, IV:0 | I:5, II:3, III:0, IV:0 | ||
Ovarian cancer | 5 (10.6%) | 10 (18.5%) | 7 (13.0%) | |
I:2, II:1, III:2, IV:0 | I:6, II:2, III:2, IV:0 | I:2, II:2, III:3, IV:0 | ||
Type of surgery | ||||
Laparoscopic or robotic surgery | 16 (34.0%) | 26 (48.1%) | 30 (55.6%) | 0.089 |
Laparotomy | 31 (66.0%) | 28 (51.9%) | 24 (44.4%) | |
Treatment of lymph node | ||||
None or biopsy | 14 (29.8%) | 29 (53.7%) | 29 (53.7%) | 0.026 * |
Lymph node dissection | 33 (70.2%) | 25 (46.3%) | 25 (46.3%) | |
Adjuvant therapy | ||||
Chemotherapy | 11 (23.4%) | 21 (38.9%) | 20 (37.0%) | 0.141 |
Radiotherapy | 12 (25.5%) | 5 (9.3%) | 6 (11.1%) | |
None | 24 (51.1%) | 28 (51.9%) | 28 (51.9%) | |
Marital status | ||||
Married | 32 (68.1%) | 32 (59.3%) | 48 (88.9%) | 0.001 * |
Unmarried | 15 (31.9%) | 22 (40.7%) | 6 (11.1%) | |
Number of children | ||||
One or more children | 28 (59.6%) | 33 (61.1%) | 43 (79.6%) | 0.053 |
No children | 19 (40.4%) | 21 (38.9%) | 11 (20.4%) | |
Smoking status | ||||
Smoker | 7 (14.9%) | 9 (16.7%) | 4 (7.4%) | 0.314 |
Non-smoker | 40 (85.1%) | 45 (85.3%) | 50 (92.6%) |
Improved or Maintained QOL | Maintained Non-Depression Status | |||
---|---|---|---|---|
81 (80.2%) | 81 (80.2%) | |||
Independent Variable | N | p-Value | N | p-Value |
Group | ||||
SH | 37 | 0.805 | 39 | 0.619 |
SM | 44 | 42 | ||
Age | ||||
<45 years | 38 | 0.809 | 39 | 1.000 |
≥45 years | 43 | 42 | ||
BMI (kg/m2) | ||||
<25 | 47 | 0.620 | 47 | 0.620 |
≥25 | 34 | 34 | ||
Cancer type | ||||
Endometrioid cancer | 46 | 47 | ||
Cervical cancer | 23 | 1.000 | 23 | 0.649 |
Ovarian cancer | 12 | 11 | ||
FIGO stage | ||||
Early stage | 56 | 0.786 | 59 | 0.283 |
Late stage | 25 | 22 | ||
Type of surgery | ||||
Laparoscopic or robotic surgery | 35 | 0.616 | 33 | 0.802 |
Laparotomy | 46 | 48 | ||
Treatment of lymph node | ||||
Lymph node dissection | 36 | 0.614 | 46 | 1.000 |
None or biopsy | 45 | 35 | ||
Adjuvant therapy | ||||
Chemotherapy or radiotherapy | 40 | 0.805 | 38 | 0.620 |
None | 41 | 43 | ||
Marital status | ||||
Married | 52 | 0.798 | 54 | 0.199 |
Unmarried | 29 | 27 | ||
Number of children | ||||
One or more children | 47 | 0.445 | 55 | 0.004 * |
No children | 34 | 26 | ||
Smoking status | ||||
Smoker | 14 | 0.732 | 12 | 0.516 |
Non-smoker | 67 | 69 |
Independent Variable | Odds Ratio (95%CI) | p-Value |
---|---|---|
FIGO stage | ||
Early stage | 1.89 (0.641–5.59) | 0.248 |
Late stage | 1 (ref) | |
Number of children | ||
One or more children | 5.04 (1.72–14.8) | 0.003 * |
No children | 1 (ref) |
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Karakida, N.; Yanazume, S.; Uchida, N.; Sakihama, M.; Douchi, T.; Kobayashi, H. Changes in Quality of Life, Depression, and Menopausal Symptoms After Surgical Menopause and the Efficacy of Hormone Replacement Therapy in Gynecological Cancer Survivors: A One-Year Prospective Longitudinal Study. Medicina 2025, 61, 1191. https://doi.org/10.3390/medicina61071191
Karakida N, Yanazume S, Uchida N, Sakihama M, Douchi T, Kobayashi H. Changes in Quality of Life, Depression, and Menopausal Symptoms After Surgical Menopause and the Efficacy of Hormone Replacement Therapy in Gynecological Cancer Survivors: A One-Year Prospective Longitudinal Study. Medicina. 2025; 61(7):1191. https://doi.org/10.3390/medicina61071191
Chicago/Turabian StyleKarakida, Noriko, Shintaro Yanazume, Natsuko Uchida, Mika Sakihama, Tsutomu Douchi, and Hiroaki Kobayashi. 2025. "Changes in Quality of Life, Depression, and Menopausal Symptoms After Surgical Menopause and the Efficacy of Hormone Replacement Therapy in Gynecological Cancer Survivors: A One-Year Prospective Longitudinal Study" Medicina 61, no. 7: 1191. https://doi.org/10.3390/medicina61071191
APA StyleKarakida, N., Yanazume, S., Uchida, N., Sakihama, M., Douchi, T., & Kobayashi, H. (2025). Changes in Quality of Life, Depression, and Menopausal Symptoms After Surgical Menopause and the Efficacy of Hormone Replacement Therapy in Gynecological Cancer Survivors: A One-Year Prospective Longitudinal Study. Medicina, 61(7), 1191. https://doi.org/10.3390/medicina61071191