Quality of life, lifestyle behavior and employment experience: a comparison between young and midlife survivors of gynecology early stage cancers.

GOALS: To evaluate differences and changes in quality of life (QoL), lifestyle behavior and employment experience of young in comparison to midlife adults in response to early stage gynecologic cancer diagnoses. METHODS: 263 patients, divided into two age groups (Group A: ≤ 45 and Group B: >45 years), were interviewed on their QoL, lifestyle behavior (dietary habits, tobacco and alcohol use, physical activity) and employment experience (employment status and working time) at diagnosis and within 4 years from the treatment. The QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and its specific modules for each cancer type (in particular endometrium, cervix, ovarian and breast). RESULTS: Global health status was significantly different between the two groups. In the younger age group a more relevant cancer interference on family life and social activities and a greater impact on perception of health status have been observed. Young women were more affected by fatigue, constipation, gastrointestinal symptoms, lymphedema, poor body image and impaired sexuality. Cancer diagnosis had a major negative impact on employment of younger patients. Conversely, younger patients had overall better health behavior. They reported a higher daily intake of fruits and vegetables, along with lower alcohol consumption, furthermore they were a little more physically active than midlife adults. CONCLUSIONS: To enhance quality of life and to promote healthy lifestyle behavior of female cancer patients, particularly in younger age, it is essential to assure multidisciplinary approaches with specific medical intervention and psychosocial supports. Indeed, midlife adults seem to have a more rapid adaptive tendency to return towards levels of well-being, following cancer diagnosis and treatment, than younger patients.

[Hysteroscopic diagnosis of cervical involvement in the staging of endometrial carcinoma]. / Diagnosi isteroscopica d'interessamento cervicale nella stadiazione del carcinoma endometriale.

Hysteroscopy could be an interesting approach to evaluate the cervical invasion by endometrial cancer. From 2003 to 2004 we performed 30 hysteroscopy with endometrial biopsy with conclusive diagnosis of endometrial carcinoma and we calculated the sensitivity and specificity of hysteroscopy in assessing tumor invasion of the uterine cervix. Our data showed an high sensitivity and specificity of hysteroscopy that reported almost the same value of the histological examination. Our conclusions are that hysteroscopy is a suitable examination in endometrial cancer staging.

[Hysteroscopy in the diagnosis of endometrial carcinoma]. / L'isteroscopia nella diagnosi del carcinoma endometriale.

OBJECTIVE: To determine the diagnostic value of hysteroscopy in endometrial cancer. METHODS: 216 patients underwent hysteroscopy and endometrial biopsy. A comparison was made between hysteroscopic impression and histological examination. RESULTS: Sensitivity of hysteroscopy for diagnosing of endometrial cancer was 83.33%, specificity was 99.04%, positive predictive value was 71.42% and negative predictive value was 99.52%. CONCLUSION: Hysteroscopy was found to have a very important role in the diagnosis of endometrial cancer.

[Hysteroscopy in suspected endometrial carcinoma: a comparison among cavity-distention media]. / Isteroscopia nel sospetto carcinoma endometriale: confronto tra mezzi di distensione cavitaria.

OBJECTIVE: To evaluate satisfaction rate, efficacy and complication rate of carbon dioxide (CO2) vs normal saline as uterine distension medium for outpatient diagnostic hysteroscopy in patients with suspicious endometrial cancer. METHODS: Thirty-eight undergoing outpatient hysteroscopy performed with carbon dioxide (group A) or normal saline (group B). Quality of vision of uterine cavity, procedure time, complications, patient discomfort, satisfaction rate have been evaluated. RESULTS: In group B a significant reduction in abdominal pain, shoulder tip pain and a lower incidence of vasovagal reactions were observed in comparison to group A. In normal saline group we found a higher satisfaction rate and a lower operative time in comparison to the CO2 group. CONCLUSIONS: Uterine distension with normal saline seems to have less adverse effects and is better accepted by patients.

[Evaluation of endometrial carcinoma using hysteroscopy and transvaginal echography]. / Valutazione del carcinoma endometriale con isteroscopia ed ecografia transvaginale.

OBJECTIVE: To compare transvaginal ultrasound and hysteroscopy in the diagnosis of endometrial cancer in women with postmenopausal bleeding. METHODS: Sixty postmenopausal women with abnormal uterin bleeding underwent to transvaginal ultrasound, hysteroscopy and endometrial biopsy. RESULTS: USG and hysteroscopy demonstrate respectively a sensitivity of 96% and 90%, specificity of 88% and 94%, positive predictive value of 86% and 92% and negative predictive value of 92% and 96% and accuracy of 89% and 94%. CONCLUSIONS: The accuracy of hysteroscopy is significantly higher than transvaginal sonography for the detection of endometrial cancer.

[Options for uterine distension during hysteroscopy]. / Alternative nella distensione cavitaria in corso di isteroscopia.

BACKGROUND: This comparative study evaluated effectiveness, complications and patient satisfaction following the use of carbon dioxide (CO2) compared with physiological solution for uterine distension during hysteroscopy. The study was motivated by doubts concerning the choice of distension methods and the implications of their use. METHODS: The study population included 189 patients attending the outpatient services of the Obstetrics/Gynecological Clinic of the University of Naples for sterility/infertility disorders. Patients were randomly assigned by computer to either of two treatment groups. Both groups underwent hysteroscopy. In Group A (92 patients), uterine distension was performed using carbon dioxide (CO2), while in Group B (97 patients) physiological solution was used. Treatment was assessed for effectiveness, causes of discomfort, patient compliance and satisfaction rate. RESULTS: Compared with carbon dioxide (CO2), the use of physiological solution as a means of uterine distension was demonstrated certain advantages that were statistically significantly for the parameters of operating time, onset of vagal reactions, causes of discomfort, compliance and satisfaction rate, and cost-effectiveness of equipment. CONCLUSIONS: The use of physiological solution for uterine distension was observed to enhance patient compliance with hysteroscopy, because the method was better tolerated, more rapid and involved fewer failures.