# APBA Kısa Özet
A meta-analysis of 13 randomized controlled trials (RCTs) involving 915 women with gynecologic cancer evaluated the impact of lifestyle and gynecologic oncology nursing interventions on health-related quality of life (HRQoL). The primary outcome was the pooled mean difference (MD) in HRQoL scores comparing intervention groups to control groups at specified time points. The analysis revealed that interventions significantly improved quality of life only in the ovarian cancer subgroup at 6 months. For other cancer types and time points, the evidence was inconclusive or showed no significant difference.
# Çalışma neyi araştırdı?
The study aimed to synthesize the best available evidence regarding the effectiveness of lifestyle and nursing interventions in enhancing the quality of life for women diagnosed with gynecologic cancers. Specifically, it sought to determine if these interventions offered significant benefits across different cancer subtypes (ovarian, endometrial, mixed) and time points (3 months, 6 months). The review focused on randomized controlled trials to assess causality and intervention efficacy.
# Yöntem
The meta-analysis followed a systematic review protocol. Researchers identified 1,123 records through comprehensive database searches conducted through June 2026. Inclusion criteria specified randomized controlled trials involving women with gynecologic cancer who received lifestyle or gynecologic oncology nursing interventions. Thirteen RCTs met the inclusion criteria, encompassing a total of 915 participants. Data were extracted regarding study characteristics, intervention types, and quality of life outcomes. Statistical analysis involved pooling mean differences (MDs) with 95% confidence intervals (CIs). Random-effects models were used for general analyses, while fixed-effect models were applied for cancer-specific subgroup analyses. Heterogeneity was assessed using the I² statistic, and the risk of bias was evaluated using standard tools.
# Temel bulgular
The pooled results demonstrated a statistically significant improvement in quality of life for women with ovarian cancer at 6 months (MD 4.28, 95% CI: 0.45-8.10, p = 0.03). Notably, this subgroup analysis showed zero heterogeneity (I² = 0%). In contrast, no significant differences in 6-month quality of life were observed for mixed cancers (MD 2.11, 95% CI: -0.90-5.12, p = 0.17; I² = 71%) or endometrial cancer at 6 months (MD 2.00, 95% CI: -1.49-5.49, p = 0.26; I² = 0%). Furthermore, at the 3-month mark, no significant difference was found for mixed cancers (MD 6.43, 95% CI: -0.16-13.01, p = 0.06; I² = 74%).
# Bulgular ne anlama geliyor?
The findings suggest that lifestyle and gynecologic oncology nursing interventions may have a targeted benefit for quality of life specifically in women with ovarian cancer during the 6-month follow-up period. The lack of significant effects in mixed and endometrial cancer groups, along with the non-significant result at 3 months for mixed cancers, indicates that the type of cancer and the timing of intervention are critical factors. The zero heterogeneity in the ovarian cancer subgroup suggests a consistent effect across the included studies for this specific population, whereas the higher heterogeneity in mixed cancer groups points to variability in study designs, intervention types, or patient characteristics that obscured a consistent treatment effect.
# Klinik önem
While the results indicate a potential benefit for ovarian cancer patients, the overall certainty of the evidence is limited. Clinicians should interpret these findings with caution. The observed improvement in quality of life for ovarian cancer patients (MD 4.28) is statistically significant but the clinical significance of this magnitude may vary. Given the imprecise nature of the evidence and the presence of heterogeneity in other subgroups, these interventions cannot be universally recommended as a standard protocol for all gynecologic cancer patients based solely on this meta-analysis. Further robust, standardized trials are needed to confirm these effects and explore mechanisms of benefit.
# Sınırlılıklar
Several limitations affect the interpretation of these results. First, there was marked heterogeneity across the included studies regarding study designs, participant characteristics, and the specific nature of the lifestyle and nursing interventions delivered. Second, the sample sizes for individual cancer subgroups were small, which reduces the statistical power to detect significant effects. Third, the risk of bias was variable across the included RCTs. Fourth, the evidence was rated as very low certainty due to indirectness and imprecision. Finally, the meta-analysis relied on aggregated data from published RCTs, which may not capture the full spectrum of clinical practice or patient experiences.