Authors: Winters BR, Wright JL, Holt SK, Dash A, Gore JL, Schade GR
Title: Health Related Quality of Life Following Radical Cystectomy: Comparative Analysis from the Medicare Health Outcomes Study.
Journal: J Urol :-
Date: 2017 Sep 04
Abstract: PURPOSE: Health related quality of life (HRQOL) after radical cystectomy (RC) and ileal conduit is not well quantified at the population level. We evaluated HRQOL in patients with bladder cancer (BC) compared with non-cancer controls (NCC) and colorectal cancer (CRC) patients using SEER-Medicare Health Outcomes Survey (MHOS) data. MATERIALS AND METHODS: SEER-MHOS data (1998-2013) was used to identify patients with BC and CRC undergoing extirpative surgery with ileal conduit or colostomy creation. 166 BC patients undergoing RC were propensity-matched 1:5 to NCC patients (N=830) and compared with 154 CRC patients. Differences in mental and physical summary scores (MCS and PCS, respectively), as well as component subscores, were determined between BC, NCC, and CRC patients. RESULTS: SEER-MHOS patients were more commonly male, of white race, with mean age of 77 yrs. (±6). RC patients had significantly lower PCS, some physical subscale scores, and all mental subscale scores compared with propensity matched NCC patients. These findings were similar among a subset of RC patients with both pre- and post-surgery data available (N=40). Global MCS scores did not differ significantly between groups. No significant differences in global MCS, PCS, or subscale scores were observed between RC and CRC patients. CONCLUSIONS: BC patients undergoing RC have significant declines in multiple components of physical and mental HRQOL verses NCC patients which mirror that of CRC patients. Further longitudinal study is required to better codify the effectors of poor HRQOL after RC to improve patient expectations and outcomes.
Last Updated: 02 Mar 2015