Lower preoperative quality of life increases postoperative risk of adverse events in women with endometrial cancer: Results from the LACE trial

Objective. To examine the association between preoperative quality of life (QoL) and postoperative adverse events in women treated for endometrial cancer. Methods. 760 women with apparent Stage I endometrial cancer were randomised into a clinical trial evaluating laparoscopic versus open surgery. This analysis includes women with preoperative QoL measurements, from the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire, and who were followed up for at least 6 weeks after surgery (n = 684). The outcomes for this study were defined as (1) the occurrence of moderate to severe adverse events within 6 months (Common Toxicology Criteria (CTC) grade >= 3); and (2) any serious adverse event (SAE). The association between preoperative QoL and the occurrence of AE was examined, after controlling for baseline comorbidity and other factors. Results. After adjusting for other factors, odds of occurrence of AE of CTC grade >= 3 were significantly increased with each unit decrease in baseline FACT-G score (OR = 1.02, 95% CI 1.00-1.03, p = 0.030), which was driven by physical well-being (PWB) (OR = 1.09, 95% CI 1.04-1.13, p = 0.0002) and functional wellbeing subscales (DNB) (OR = 1.04, 95% CI 1.00-1.07, p = 0.035). Similarly, odds of SAE occurrence were significantly increased with each unit decrease in baseline FACT-G score (OR -= 1.02, 95% CI 1.01-1.04, p = 0.011), baseline PWB (OR = 1.11,95% CI 1.06-1.16, p <0.0001) or baseline FWB subscales (OR = 1.05, 95% CI 1.011.10, p = 0.0077). Conclusion. Women with early endometrial cancer presenting with lower QoL prior to surgery are at higher risk of developing a serious adverse event following surgery. (C) 2015 Elsevier Inc. All rights reserved.