Patient-reported outcomes for patients undergoing radical cystectomy: a prospective case-control study

Support Care Cancer. 2014 Jan;22(1):189-200. doi: 10.1007/s00520-013-1946-9. Epub 2013 Sep 13.

Abstract

Purpose: The purpose of this study was to measure patient-reported outcomes (PROs) for patients with muscle-invasive bladder cancer (BC) before the diagnosis of BC was known, thus before cystectomy, and until 1 year postcystectomy. The differences in outcomes between a health status (HS) and quality of life (QoL) questionnaires were examined.

Methods: From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this prospective, multi-centre case-control (CC) study. Patients undergoing radical cystectomy (RC; N = 18) were compared with patients with other causes of hematuria (CC, N = 20). Measurement points were before diagnosis as well as 3, 6 and 12 months postcystectomy. Questionnaires used were the WHOQOL-BREF, SF-12, International Index of Erectile Function, and 10-item STAI-Trait scale.

Results: Prediagnosis patients who later appeared to have BC had the same QoL compared to CC patients. The prediagnosis physical component scale of HS and sexual function were significantly lower for RC vs. CC patients. RC patients had a better prediagnostic QoL and HS than postcystectomy at all time points.

Conclusions: This is the first case-control study with a baseline measurement of PROs before the diagnosis of BC was known. It shows lower physical health and sexual function for RC vs. CC before diagnosis is known. Until 1 year postcystectomy, QoL does not return to baseline level. Future studies including comorbidity and smoking history are needed to examine the generalizability of our results.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Comorbidity
  • Cystectomy / adverse effects
  • Cystectomy / psychology
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Self Report
  • Treatment Outcome
  • Urinary Bladder Neoplasms / psychology*
  • Urinary Bladder Neoplasms / surgery*