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Quality of Life and Sexual Function after Type c2/Type III Radical Hysterectomy for Locally Advanced Cervical Cancer: A Prospective Study


Francesco Plotti, MD, Sapienza University, Department of Obstetrics and Gynecology, viale del Policlinico 155, Rome 00161, Italy. Tel: +39 06 4997615; Fax: +39 06 4997615; E-mail:


Introduction.  The introduction of screening programs have made cervical cancer detectable at earlier stages and in younger patients. Nevertheless, only a few studies have examined the QoL and sexual function in disease-free cervical cancer survivors.

Aim.  The objective of this study is to evaluate the sexual function in a cervical cancer patient's group treated with neoadjuvant chemotherapy (NACT) plus type C2/type III radical hysterectomy (RH).

Methods.  We have enrolled in the oncologic group (OG) sexually active patients affected by cervical cancer (stage IB2 to IIIB) treated with NACT followed by RH.

Main Outcome Measures.  Included subjects were interviewed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CX24 Questionnaire. Two consecutive assessments were recorded: at the first evaluation postoperatively (T1) and at the 12-month follow-up visit (T2). Results were compared with a benign gynecological disease group (BG) and with a healthy control group (HG).

Results.  A total of 33 patients for OG, 37 for BG, and 35 women for HG were recruited. After surgery, sexual activity has been resumed by 76% of the OG patients and 83.7% of the BG patients (P = not significant). Cancer survivors had clinically worse problems with symptom experience, body image, and sexual/vaginal functioning than controls (P < 0.05). OG patients also reported more severe lymphedema, peripheral neuropathy, menopausal symptoms, and sexual worry. For sexual activity, the score difference between cancer survivors and women with benign gynecological disease is not statically significant. Concerning sexual enjoyment assessment, our study shows comparable results for OG and BG.

Conclusion.  Nevertheless, the worsening of symptom experience, body image, and sexual/vaginal functioning, OG patients have same sexual activity and sexual enjoyment data compared with those of BG patients. Thus, NACT followed by RH could be a valid therapeutic strategy to treat and improve well-being especially in young cervical cancer patients. Plotti F, Sansone M, Di Donato V, Antonelli E, Altavilla T, Angioli R, and Panici PB. Quality of life and sexual function after type c2/type III radical hysterectomy for locally advanced cervical cancer: A prospective study. J Sex Med 2011;8:894–904.