Sexuality as a prognostic factor: Results of an individual participant data NOGGO-meta-analysis of 1,041 recurrent ovarian cancer patients before starting chemotherapy.

person Nicole Balint Charite-Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany info_outline Nicole Balint, Adak Pirmorady-Sehouli, Rolf Richter, Dario Zocholl, Hannah Woopen, Klaus Pietzner, Jalid Sehouli

Authors person Nicole Balint Charite-Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany info_outline Nicole Balint, Adak Pirmorady-Sehouli, Rolf Richter, Dario Zocholl, Hannah Woopen, Klaus Pietzner, Jalid Sehouli Organizations Charite-Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany, Charite-Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery and Berlin Institute of Health, Campus Virchow Klinikum, Berlin, Germany, Charité - University Medicine of Berlin, corporate member of Free University of Berlin and Humboldt University of Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany, North-Eastern German Society of Gynaecological Oncology (NOGGO) and Charite-Universitätsmedizin Berlin, Department of Gynecology with Center for Oncological Surgery, Campus Virchow Klinikum, Berlin, Germany Abstract Disclosures Research Funding No funding received None. Background: Until now there is very little data available about sexuality in ovarian cancer patients. Aim was analyze if sexuality is associated with clinical parameters, quality of life, prior discontinuation of chemotherapy and survival in recurrent ovarian cancer patients before starting chemotherapy. Methods: Raw data including the QLQ-C30 and QLQ-OV28 EORTC questionnaire from four phase II/III trials (“Tower”, “Treosulfan”, “Hector” and “TRIAS”) conducted by the North-Eastern German Society of Gynecological Oncology (NOGGO) were synthesized for this individual participant data meta-analysis using ANOVA and cox regression analyses. All study participants were diagnosed with recurrent ovarian cancer and data for this analysis was gained before starting chemotherapy. Three patient groups were defined: (1) patients without interest in sex and not being sexually active, (2) patients with interest in sex and not being sexually active and (3) patients with interest in sex and being sexually active. Results: Data on sexuality was available from 644 patients with 437 patients without interest in sex and not being sexually active (1), 45 patients with interest in sex and not being sexually active (2) and 162 patients with interest in sex and being sexually active (3). Women of the third group were significantly younger with a median age of 57 years at randomization compared to women of group (1) with a median age of 65 years, p < 0.001. Women with interest in sex and who were sexually active showed also a significant better ECOG performance status (p < 0.001), had a lower number of recurrences (p < 0.001) and had less frequently ascites at diagnosis (p < 0.002). There were no differences regarding FIGO stage, BMI and grading between the three groups. Sexuality was associated with global quality of life (p < 0.001) and physical, psychological, social, emotional and role functionality (p < 0.001). Patients who were sexually active, reported less fatigue (p < 0.001), less pain (p < 0.001), less sleeping disorders (p = 0.004), less diarrhea (p = 0.008), less nausea and vomiting (p = 0.007) and less loss of appetite (p < 0.001). There was no association with prior discontinuation of chemotherapy. Median overall survival (OAS) was 16.7 months in platinum-resistant patients being sexually active compared to a median OAS of 8.7 months in platinum-resistant patients who are not sexually active (p = 0.016). Conclusions: Medical personnel should routinely address sexuality in ovarian cancer patients as sexuality seems to be a marker for both QoL and overall survival and warrants further investigation.