Assessment of quality of life after cystectomy or conservative therapy for patients with infiltrating bladder carcinoma: A survey by a self‐administered questionnaire

BACKGROUND Quality of life (QOL) has rarely been assessed in nonmetastatic bladder cancer patients (NMBC). Therefore, very little information is available for comparing the impact of different treatments on QOL for patients affected by NMBC. METHODS We developed an “ad hoc” self‐administered questio...

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Bibliographic Details
Published in:Cancer 1996-09, Vol.78 (5), p.1089-1097
Main Authors: Caffo, Orazio, Fellin, Gianni, Graffer, Umberto, Luciani, Lucio
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Biological and medical sciences
bladder carcinoma
chemotherapy
Combined Modality Therapy
cystectomy
Cystectomy - psychology
Diarrhea - epidemiology
Female
Humans
Incidence
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Population Surveillance
Quality of Life
radiotherapy
Sexual Behavior - psychology
Social Behavior
Surveys and Questionnaires
Tumors of the urinary system
Urinary Bladder Neoplasms - psychology
Urinary Bladder Neoplasms - therapy
Urinary tract. Prostate gland
Urination Disorders - epidemiology
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Summary:BACKGROUND Quality of life (QOL) has rarely been assessed in nonmetastatic bladder cancer patients (NMBC). Therefore, very little information is available for comparing the impact of different treatments on QOL for patients affected by NMBC. METHODS We developed an “ad hoc” self‐administered questionnaire and evaluated its psychometric properties. We then carried out a retrospective study by mailing the questionnaire to a consecutive series of 93 patients treated for NMBC between 1981 and 1994. The patients were treated either with a conservative approach (CT), based on radiotherapy with or without chemotherapy, or with cystectomy followed by urostomy (US). RESULTS Twenty‐nine questionnaires (66%) mailed to conservatively treated patients and 30 (61%) mailed to cystectomized patients were returned. The questionnaire used in the study showed sufficient psychometric properties: an α‐Cronbach coefficient > 0.8 was reached and validity was established in all of its aspects. The items were grouped into seven subscales reflecting different QOL domains. The two treatment groups reported differences in QOL adjustment. QOL after cystectomy, marked by stoma presence, was reduced by a lack of sexual activity and a worsened physical condition, but social and recreational life were little affected. Conversely, a low incidence of urinary symptoms and an acceptable sexual adjustment were found in the CT sample; the physical, psychologic, and sociorelational adjustments were also good. QOL in the CT group was consistently better than in the US group. All subscale scores were higher in the CT group than in the US group, with a statistically significant difference in four of six subscales. CONCLUSIONS QOL is better after conservative therapy than after cystectomy, as expected. Prospective studies with repeated measurements covering all fields of interest in QOL would offer an accurate assessment of QOL in NMBC patients. Cancer 1996;78:1089‐97.
ISSN:0008-543X
1097-0142
DOI:10.1002/(SICI)1097-0142(19960901)78:5<1089::AID-CNCR20>3.0.CO;2-Y