MP38-18 SELF-REPORTED QUALITY OF LIFE AS A PREDICTOR OF MORTALITY IN BLADDER AND UPPER TRACT MALIGNANCIES

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP38)1 Sep 2021MP38-18 SELF-REPORTED QUALITY OF LIFE AS A PREDICTOR OF MORTALITY IN BLADDER AND UPPER TRACT MALIGNANCIES Ridwan Alam, Sunil Patel, Max Kates, Nirmish Singla, Trinity Bivalacqua, and Phillip Pierorazio Ridwan AlamRidwan Alam More articles by this author , Sunil PatelSunil Patel More articles by this author , Max KatesMax Kates More articles by this author , Nirmish SinglaNirmish Singla More articles by this author , Trinity BivalacquaTrinity Bivalacqua More articles by this author , and Phillip PierorazioPhillip Pierorazio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002053.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Quality of life (QOL) metrics in cancer patients may provide prognostic value not captured by traditional demographic and disease parameters. We evaluate the utility of self-reported QOL to predict mortality in patients with bladder cancer (BCa) or upper tract urothelial carcinoma (UTUC). METHODS: Using the Surveillance, Epidemiology, and End Results – Medicare Health Outcomes Survey database, patients who completed a QOL questionnaire after the diagnosis of BCa or UTUC were identified. Multivariable regression models assessed associations of mental component summary (MCS) and physical component summary (PCS) scores with all-cause, cancer-specific, and non-cancer-specific mortality. For the competing risks regression, MCS and PCS scores were classified as high (≥50; +) or low (<50; –) based on a population mean score of 50 points. Harrell’s concordance statistic (C-index) and Akaike Information Criteria (AIC) determined predictive accuracy and parsimony, respectively. RESULTS: A total of 1251 patients (1157 BCa, 94 UTUC) with a median follow-up time of 2.3 years (IQR 1.1-4.3) were included. There were 576 deaths, of which 92 were cancer-specific mortalities. There were no significant differences in mortality between the BCa and UTUC groups. Regression analysis demonstrated that each additional MCS and PCS point reduced the hazard of all-cause mortality by 1.2% (95% CI 0.982-0.995, p=0.001) and 2.6% (0.967-0.982, p<0.001), respectively. Models with QOL metrics demonstrated improved predictive accuracy (C-index 71.1% vs 67.6%) and parsimony (AIC 7357.5 vs 7420.8) than models without QOL metrics. On competing risks analysis, patients with low PCS scores were at higher risk of non-cancer-specific mortality compared to their counterparts with high PCS scores (Figure). There was no association between QOL metrics, both mental and physical, and cancer-specific mortality. CONCLUSIONS: Self-reported QOL metrics can be used to predict mortality in BCa and UTUC patients with improved accuracy and parsimony. The incorporation of QOL metrics should be considered in prognostic models and patient counseling for these disease processes. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e701-e702 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ridwan Alam More articles by this author Sunil Patel More articles by this author Max Kates More articles by this author Nirmish Singla More articles by this author Trinity Bivalacqua More articles by this author Phillip Pierorazio More articles by this author Expand All Advertisement Loading ...