Comparison of surgery or radiotherapy on complications and quality of life in patients with the stage IB and IIA uterine cervical cancer

Objectives: To compare the long-term complications and quality of life of patients with stage IB and stage IIA uterine cervical carcinoma treated by surgery or radiotherapy. Methods: From August 2003 to May 2004, 202 patients with uterine cervical carcinoma were treated with surgery or radiotherapy at two institutions and were enrolled in this study upon follow-up at least 2 years post treatment. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and complications Questionnaire. Results: Constipation (p < 0.001), flushing (p < 0.001), dysuria (p < 0.001), urinary incontinence (p < 0.01), dysparia (p < 0.05) and vaginal dryness (p < 0.05) were statistically higher in the surgery treated group, while diarrhea (p < 0.001), bloody stools (p < 0.001) and abdominal pain (p < 0.01) were higher in the radiotherapy group. Using factor analysis and introducing personal conditioned variables, pelvic neural dysfunction was significantly higher in surgery group and intestinal dysfunction was higher in radiotherapy group. There was no difference in sexual dysfunction between these two modalities. Comparison of EORTC QLQ-C30 showed that the majority of issues had minimal differences between these two treatment modalities, except social functioning (p < 0.05; higher in radiotherapy group), constipation (p < 0.001; higher in surgery group) and diarrhea (p < 0.01; higher in radiotherapy group). Conclusions: In early stage uterine cervical cancer patients, surgery or radiotherapy resulted in different complications, whereas long-term quality of life showed few differences between these two different modalities. These data were helpful for physicians in regards to the changes of patients, and moreover, for rehabilitation and supportive care of the patients after treatment.