The impact on sexual wellbeing after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer treatment.

BACKGROUND

Adding hyperthermic intraperitoneal chemotherapy (HIPEC) to extensive cytoreductive surgery (CRS) for advanced ovarian cancer (OC) raises concerns about sexual morbidity, yet, sexual wellbeing is largely overlooked in CRS/HIPEC trials and practice. We evaluated the sexual wellbeing of OC survivors after CRS/HIPEC.

METHODS

This single center cross-sectional study surveyed FIGO stage III-IV OC patients who underwent primary CRS/HIPEC ≥ 3 months prior using an anonymous survey and the EORTC QLQ-SHQ22 questionnaire. Sexual satisfaction and pain scales were linearly transformed (0-100), with higher scores indicating higher satisfaction and more pain. Qualitative themes were identified from a single open-ended survey question.

RESULTS

Overall, 33/68 (48.5%) patients completed questionnaires. Most were aged 61-80 years (66.7%), heterosexual (97.0%), had CRS/HIPEC > 1 year prior (81.8%), and reported an active sex life as "not at all" / "a little" important (72.7%). Mean sexual satisfaction score was 31 ± 26. A negative change in their sexual wellbeing was reported by 13/14 (92.8%), which was associated with lower sexual satisfaction (p = 0.024). Greater sexual satisfaction was associated with regular exercise (p = 0.025), absence of comorbidities (p = 0.041), and sexual health support from providers (p = 0.019). All patients reported sexual morbidity; vaginal dryness/hot flashes (14/33, 42.4%) were most common. Only 33% (11/33) of patients received sexual wellbeing-related healthcare support, of whom 72.7% found it useful. Of 3 identified themes, "Other Priorities" was the most common.

CONCLUSIONS

Changes in sexual wellbeing after CRS/HIPEC were common, but healthcare support was limited. Those receiving support reported higher sexual satisfaction. Sexual wellbeing was reframed within broader survivorship priorities.