Prospective assessment of patient perception and quality of life in gynecologic patients after pelvic exenteration.

10082 Background: Pelvic exenteration (PE) is surgical procedure associated with significant morbidity offered to select women with centrally recurrent gynecologic cancers. This ongoing study aims to examine multifaceted quality of life (QOL) domains and patient satisfaction with PE. Methods: Since January 2009, prospectively enrolled participants completed questionnaires evaluating body image (BIS), depression (CESD), social support (DUFSS), symptoms (MDASI), sexual function (SAQ), QOL (SF-12, Stoma-QOL), bladder QOL (FACT-BL), satisfaction with decision (SWD) and an investigator-designed survey at baseline, 4-6 weeks, 6 and 12 months after PE. Mann-Whitney and Wilcoxon signed-rank tests were used to evaluate the data. Results: 52 women enrolled; 22 completed surveys at baseline and 1 year. Median age was 60 years (range 37, 76). Median BMI was 31.5 kg/m2. 75% were white. Cancer diagnoses included 40% cervix, 21% uterine, 19% vaginal, 17% vulvar and 2% ovarian. 78% underwent a total PE. As measured by SF-12, physical (PCS) and mental component scores (MCS) decreased at 6 months (p = 0.01; p = 0.03) but returned to baseline at 1 year (PCS p = 0.10; MCS p = 0.29). Bladder-related QOL declined at 4-6 weeks (p = 0.003), returned to baseline at 6 months (p = 0.36) and remained stable at 1 year (p = 0.11). Body image declined at 1 year (p = 0.03). At baseline, 38% of women reported sexual activity. At 1 year, sexually active women (22%) had reduced sexual pleasure (p = 0.02); sexual discomfort remained stable (p = 0.58). Physical problems (44%) and lack of interest (35%) accounted for sexual inactivity at 1 year. Women remained satisfied with their decision for PE between 6 and 12 months (p = 0.44). At 6 months, 82% of women reported that they would have a PE again; the remainder were unsure. Depression levels, social support, symptom assessment and stoma-QOL remained stable over the study period. Conclusions: Despite a transient decrease in QOL, persistent low body image and sexual dysfunction, most women were satisfied with their decision and would undergo a PE again. This finding supports the use of PE in properly selected women, while identifying QOL domains that should be supported during survivorship care.