Publication Abstract

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 05

Abstract: PURPOSE: Health related quality of life after radical cystectomy and ileal conduit creation is not well quantified at the population level. We evaluated health related quality of life in patients with bladder cancer compared with noncancer controls and patients with colorectal cancer patients using data from SEER (Surveillance, Epidemiology and End Results)-MHOS (Medicare Health Outcomes Survey). MATERIALS AND METHODS: SEER-MHOS data on 1998 to 2013 were used to identify patients with bladder cancer and those with colorectal cancer who underwent extirpative surgery with ileal conduit or colostomy creation. A total of 166 patients with bladder cancer treated with radical cystectomy were propensity matched 1:5 to 830 noncancer controls and compared with 154 patients with colorectal cancer. Differences in mental and physical summary scores using the Mental Component Summary and the Physical Component Summary, respectively, as well as component subscores were determined between patients with bladder cancer, patients with colorectal cancer and noncancer controls. RESULTS: SEER-MHOS patients were more commonly male and white with a mean SD age of 77 6 years. Patients treated with radical cystectomy had significantly lower Physical Component Summary scores, some lower physical subscale scores and all lower mental subscale scores compared with propensity matched noncancer controls. These findings were similar in the subset of 40 patients treated with radical cystectomy who had available preoperative and postoperative data. Global Mental Component Summary scores did not differ significantly between the groups. No significant differences were observed in global Mental Component Summary, Physical Component Summary or subscale scores between patients treated with radical cystectomy and patients with colorectal cancer. CONCLUSIONS: Patients with bladder cancer who undergo radical cystectomy have significant declines in multiple components of physical and mental health related quality of life vs noncancer controls, which mirror those of patients with colorectal cancer. Further longitudinal study is required to better codify the effectors of poor health related quality of life after radical cystectomy to improve patient expectations and outcomes.