Psychological distress and its influencing factors in survivors of malignant ovarian germ cell and sex-cord stromal tumors & mdash;an analysis of the AGO-CORSET T database

Background: Sex cord-stromal tumors (SCST) and malignant ovarian germ cell tumors (MOGCT) are rare ovarian neoplasms that disproportionally affect young women. As prognosis is excellent throughout all stages, quality of life issues are important topics for long-term survivors.Aims: To investigate the prevalence of fertility-preserving therapy in patients with ovarian stromal tumors and germ cell tumors and to evaluate factors influencing anxiety, depression, quality of life, and sexuality.Materials and methods: The Current Ovarian geRm cell and SEx cord stromal Tumor Treatment strategies (CORSETT) study is an observational, multicenter, mixed retrospective/prospective cohort study of the "Arbeitsgemeinschaft fur Gynakologische Onkologie " (AGO) study group. Women who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete questionnaires (Hospital Anxiety and Depression Scale [HADS], Sexual Activity Questionnaire [SAQ], European Organisation for Research and Treatment of Cancer Core Quality of life Questionnaire [EORTC QLQ-C30]). This analysis focused on the value of fertility-preserving surgery and the relevance of factors influencing pain, anxiety, and depression on quality of life for survivors.Results: Of the 355 patients included, 152 women completed the questionnaires and thus were included in this analysis. In all, 85 (56%) had fertility-sparing surgery. Furthermore, 34% had significant levels of depression and anxiety. Women with fertility-conserving treatment had a higher probability for being sexually active and had less depression and anxiety. Pain was associated with the level of distress, irrespective of the time since diagnosis.Discussion: Fertility-sparing surgery should be offered to all SCST and MOGCT patients, when oncologically safe, in order to ensure the best possible quality of life for cancer survivors. Questionnaires evaluating depression, anxiety, pain, and sexuality should be routinely used during treatment and follow-up.