Predictors of quality of life in non-muscle-invasive bladder cancer survivors.

Abstract

193 Background: Non-muscle-invasive bladder cancer (NMIBC) survivors face frequent invasive surveillance cystoscopies, repeated treatment, and the highest recurrence rates and medical cost among all cancer survivors for the remainder of their lifespan. Despite the burdens of survivorship for this group, very little is known about the quality of life (QOL) impact of NMIBC diagnosis. We identified factors associated with QOL in NMIBC survivors. Methods: 2000 patients were randomly selected from the 5979 NMIBC population diagnosed between 2010-2014 in North Carolina. These patients received a mailed survey including cancer-specific (EORTC QLQ-C30) and NMIBC-specific (QLQ-NMIBC24) measures of QOL. QOL in this population was described, and hierarchical multiple linear regression was used to determine which patient and disease characteristics are associated with QOL. Results: 376 survivors were included in the analyses (response rate 22%). The mean QOL scores for the following domains include (range 0- 100, higher score is better in all domains but symptoms): global health 73.6±21.7, function 84.8±18.5, symptoms 15.5±17.2, NMIBC-specific sexual function 31.5±27.1 and NMIBC-specific sexual enjoyment 48.1±38.1. Survivors reporting significantly lower global health status were more likely to be male (p < .01), lower income (p = .02), stage Tis at diagnosis (p < .01), and have lower cognitive abilities (p < .01). Lower function (p < .01) and higher symptoms (p = .01) were seen in survivors who were not cured or unsure whether were cured (vs. cured). Lower global health status (p < .01) and higher symptoms (p < .01) were found in survivors who had not received intravesical immunotherapy. Lower social support was associated with lower global health status (p < .01) and lower function (p < .01). A higher number of comorbidities and more cognitive general concerns were associated with poorer QOL in all domains (all p < .01). Conclusions: We identified correlates of QOL in NMIBC survivors. Special attention should be given to those with high risk of lower QOL, including patients with more comorbidities, more cognitive general concerns, or lower social support.