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Reproductive and Sexual Function After Platinum-Based Chemotherapy in Long-Term Ovarian Germ Cell Tumor Survivors: A Gynecologic Oncology Group Study

David M. Gershenson, Anna M. Miller, Victoria L. Champion, Patrick O. Monahan, Qianqian Zhao, David Cella, Stephen D. Williams

From the Department of Gynecologic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX; Indiana University Cancer Center; School or Nursing; School of Medicine, Indiana University, Indianapolis, IN; and the Evanston Northwestern Healthcare, Northwestern University Feinberg School of Medicine, Evanston, IL

Address reprint requests to David M. Gershenson, MD, The University of Texas, M.D. Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439; e-mail: dgershen{at}mdanderson.org

Purpose: To compare malignant ovarian germ cell tumor survivors with a matched control group of females on menstrual and reproductive outcomes, sexual functioning, and dyadic adjustment.

Patients and Methods: Eligible patients met the following criteria: (1) history of malignant ovarian germ cell tumor; (2) treatment with surgery plus platinum-based chemotherapy; (3) age at least 18 years and continuously disease-free with minimum follow-up of 2 years; (4) capability of completing questionnaire and telephone interview; and (5) completion of written informed consent. The control group was drawn from acquaintances recommended by survivors and matched for age, race, and education. Scales with established reliability and validity were used to measure quality-of-life concepts of sexual functioning and social networks.

Results: One hundred thirty-two survivors and 137 controls completed the study. Of 132 survivors, 71 (53.8%) had fertility-sparing surgery. Of fertile survivors, 62 (87.3%) reported still having menstrual periods. Twenty-four survivors reported 37 offspring after cancer treatment. Compared with controls, survivors had significantly greater reproductive concerns (P < .0001), less sexual pleasure (P = .003), and lower scores on the total Sexual Activity Scale Score (P = .001). However, survivors had better dyadic consensus (P = .004), dyadic satisfaction (P = .005), and dyadic cohesion (P = .014).

Conclusion: Women who had fertility-sparing surgery were very likely to retain menstrual function and fertility after chemotherapy. Although there is some increase in gynecologic symptoms and diminution in sexual pleasure, survivors tended to have stronger, more positive relationships with significant others.

This study was supported by National Cancer Institute (NCI) R01 grant CA77470 and NCI grants to the Gynecologic Oncology Group Administrative Office (CA 27469) and the Gynecologic Oncology Group Statistical Office (CA 37517).

Presented in part at the 38th Annual Meeting of the of the American Society of Clinical Oncology, Orlando, FL, May 18-21, 2002.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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