Understanding Contemporary Endometrial Cancer Survivorship Issues: Umbrella Review and Healthcare Professional Survey

了解当代子宫内膜癌生存问题:综合综述和医疗保健专业人员调查

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Abstract

Background/Objectives: Advances in endometrial cancer treatment, such as minimally invasive surgery and the introduction of targeted therapies, could influence survivorship and result in changes in issues experienced by survivors of endometrial cancer. To improve endometrial cancer survivorship, it is first necessary to understand it. Therefore, the purpose of this study was to describe contemporary endometrial cancer survivorship issues. Methods: This study involved an umbrella review and cross-sectional survey of healthcare professionals. The umbrella review involved searching Medline (2013-2023) to identify published reviews describing survivorship outcomes in endometrial cancer survivors. Articles were screened and survivorship outcomes were extracted. Healthcare professionals working with patients diagnosed with endometrial cancer were asked to (1) rate the relevance of each survivorship outcome identified in the review, and (2) list any additional issues considered of clinical relevance. Results: Following the screening of 201 articles (159 papers excluded: n = 1 duplicate; n = 158 ineligible), 42 review articles were included and 25 survivorship outcomes identified including physical health (e.g., fatigue, pain), fertility (e.g., parity), quality of life (e.g., cognitive wellbeing), treatment-related toxicities, and mental health outcomes (e.g., anxiety). The cross-sectional survey was completed by 37 healthcare professionals (two-thirds being medical oncologists or gynaecological oncologists) working across Australia and New Zealand, with outcomes rated as relevant by 30% (for cachexia) to 100% (for body weight/obesity and functional wellbeing of respondents. An additional 28 survivorship issues not identified in the review were reported by healthcare professionals. Conclusions: The current endometrial cancer survivorship literature is limited. The review, together with expert input from healthcare professionals, identified 53 survivorship issues. These findings will now inform development of a survey to explore the frequency, impact, and severity of survivorship issues from the perspective of endometrial cancer survivors, the results of which will guide the provision of supportive cancer care, in addition to guiding research and clinical practice.

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