Climacteric Symptoms in Postoperative Patients Among Endometrial Cancer, Cervical Cancer, and Ovarian Cancer: A Cross-Sectional Study

Abstract Background: No studies have assessed climacteric symptoms after hystero-adnexectomy for endometrial, cervical, or ovarian cancer. Thus, this study aimed to compare climacteric symptoms among patients who underwent surgery for these three cancer types.Methods: We included patients who were registered at a menopausal outpatient clinic between January 1999 and July 2016 after undergoing total hysterectomy, intrapelvic only or intrapelvic plus para-aortic lymph node dissection, and bilateral adnexectomy performed via laparotomy as cancer treatment. The numbers of patients with endometrial, ovarian, and cervical cancer were 328, 90, and 107, respectively. We collected the following data: age at surgery, time since surgery, body mass index, menopausal status at surgery, and postoperative adjuvant therapy. Climacteric symptoms were assessed using a patient-reported questionnaire covering 40 parameters. Each symptom was graded from 0 (no symptoms) to 3 (severe symptoms). The total for all 40 parameters was considered as the degree of symptom severity.Results: Multivariate analysis revealed that time since surgery and cancer type had statistically significant effects on climacteric symptom severity. Overall, climacteric symptoms were more severe in patients with cervical cancer than in those with endometrial or ovarian cancer; symptom severity decreased with increasing time since surgery. However, in patients with cervical cancer, symptom severity did not decrease significantly over time, even after >5 years had elapsed since surgery.Conclusions: The severity of climacteric symptoms decreased with time after surgery for patients with endometrial or ovarian cancer but not for those with cervical cancer. Patients with cervical cancer may require more prompt interventions, including symptomatic treatment, and longer follow-up than those with endometrial or ovarian cancer.