A comprehensive model for gynecologic cancer patients' survivorship care

OBJECTIVES: The population of gynecologic cancer survivors is rapidly increasing, yet survivorship care remains fragmented and often focused primarily on surveillance for disease recurrence. This review aims to define the key domains shaping survivorship and propose a comprehensive, patient-centered model for gynecologic oncology. METHODS: Our narrative reviews and synthesizes current evidence and clinical perspectives to examine gynecologic cancer survivorship. We organize the analysis around four clinically relevant pillars: menopause management, sexual health and function, psychosocial health, and nutrition and physical activity. Evidence was summarized and gaps in care are identified to inform a comprehensive survivorship framework. RESULTS: Gynecologic cancer survivors experience complex and interrelated long-term sequelae. Treatment-induced menopause contributes to substantial symptom burden and increased risk of chronic disease. Sexual dysfunction is highly prevalent yet frequently underrecognized in clinical care. Psychosocial challenges, including depression, anxiety, fear of recurrence, and financial toxicity, are common and persistent. Nutrition and physical activity influence quality of life, physical functioning, and survival outcomes, although gynecologic cancer-specific evidence remains limited. Deficiencies in routine screening and assessment across survivorship domains, clinician knowledge and training, and access to multidisciplinary interventions contribute to unmet survivorship needs. CONCLUSIONS: Survivorship care in gynecologic oncology requires a structured, holistic, and multidisciplinary approach that extends beyond surveillance for disease recurrence. Integrating menopause care, sexual health support, psychosocial services, and lifestyle interventions into routine care is essential to address unmet needs and improve long-term outcomes. A comprehensive model centered on these four pillars provides a practical framework for screening, intervention, and multidisciplinary survivorship care aimed at improving long-term quality of life and health outcomes.