Quality of life in long-term survivors of muscle-invasive bladder cancer.

Abstract

319 Background: Health-related quality of life (QOL) is not well-studied in survivors of muscle-invasive bladder cancer (MIBC). This cross-sectional multi-institutional study compared long-term QOL in MIBC patients treated with bladder-sparing trimodality therapy (TMT) vs. radical cystectomy (RC). Methods: Patients with non-metastatic cT2-T4 MIBC, diagnosed in 1990-2011 and disease-free for ≥2 years were identified. A questionnaire using validated general and disease-specific QOL instruments was administered (score ranges: 0-100). Results: Of 226 eligible patients, 173 returned the questionnaire for a response rate of 77%. Sixty-four received TMT and 109 RC (89 with ileal conduit and 18 with neobladder diversions). The median time from diagnosis to questionnaire was 9 vs. 6 years, respectively (p=0.009). Comparing TMT to RC, there was no significant difference in age at diagnosis or questionnaire, gender, smoking, clinical stage or comorbidities. On univariable analysis (UVA), patients who received TMT had significantly better general QOL than patients who received RC by 4.8 points on the EQ-5D 3L and 7.4 points on the EORTC QLQ-C30 (Table). On multivariable analysis (MVA), adjusting for age, time from diagnosis, year of treatment, gender and comorbidities, patients who received TMT had significantly better general QOL by an average 6-7 points. On MVA, TMT was associated with significantly better bowel function by an average 4.5 points on the EPIC bowel function subscale, but with no difference in bowel bother. Urinary QOL was equivalent between groups, as measured by the EORTC QLQ-BLM30. Conclusions: While both TMT and RC provide good long-term outcomes, TMT appears to be associated with higher general QOL and bowel function compared to RC. [Table: see text]