Return to work in patients undergoing different rehabilitation programs following surgical treatment of early-stage female cancers: results of a prospective longitudinal study with randomization at baseline

Background. Surgical treatment remains the primary method of radical therapy for early-stage female cancers. However, it may be accompanied by complications associated with post-ovariectomy syndrome and distress. These complications, including sexual dysfunction as well as physical and psychosocial disorders, negatively impact patients’ quality of life and professional activity, which highlights the need to develop effective rehabilitation strategies aimed at restoring working capacity after treatment.

Objective: To assess the impact of different rehabilitation programs on the return to work among female patients following surgical treatment for early-stage cervical cancer (CC) and endometrial cancer (EC).

Material and methods. A prospective longitudinal study included 164 adult women aged 18 years and older with stage IA/IB CC and stage I/II EC. The patients were divided into the following groups: CC-1 (n=51) and EC-1 (n=29) – who underwent a full course of comprehensive "active" rehabilitation, including lifestyle modification, physiotherapy, psychological support, and other interventions within 12 months after radical surgical treatment; CC-2 (n=52) and EC-2 (n=32) – who underwent a "passive" rehabilitation, i.e., received recommendations in accordance with the current clinical guidelines at the time of study enrollment. Follow-up was performed at 24 and 36 months following surgery.

Results. In the groups that underwent comprehensive "active" rehabilitation, patients returned to work earlier compared to those undergoing "passive" rehabilitation, starting from the third month of follow-up. At 36 months after surgery, all patients in the CC-1 group and 90.9% of patients in the EC-1 group returned to work, whereas only 66.7% in the CC-2 group and 55.6% in the EC-2 group returned. The likelihood of returning to professional activity was significantly higher in the CC-1 and EC-1 groups compared to the CC-2 and EC-2 groups (OR 0.467, 95% CI 0.309–0.706, p<0.001 vs. OR 0.548, 95% CI 0.440–0.684, p<0.001, respectively).

Conclusion. Personalized comprehensive rehabilitation programs significantly increase the likelihood of recovery of work capacity and accelerate this process in female patients following surgical treatment of gynecologic cancers. The findings support the importance of comprehensive "active" rehabilitation for social reintegration and improved long-term outcomes. Further research should focus on optimizing the components of such programs and integrating them into routine clinical practice.

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