The impact of physician specialty on general and bladder cancer-specific quality of life among patients with muscle invasive bladder cancer.

Abstract

462 Background: Treatment delivery for muscle invasive bladder cancer (MIBC) may involve general urologists, urologic oncologists or a multidisciplinary team that includes medical oncology and radiation oncology. Our objective was to evaluate differences in general and bladder cancer-specific quality of life (QOL) based on treating physician among MIBC patients. Methods: We performed a cross-sectional survey of bladder cancer patients using the Bladder Cancer Advocacy Network Patient Survey Network and Inspire platforms to determine general and bladder cancer-specific QOL using the EORTC QLQ-C30 and Bladder Cancer Index, respectively. Patients were also queried regarding demographic, socioeconomic and clinical characteristics. Patients were asked whether they sought care from a general urologist, urologic oncologist, medical oncologist and/or radiation oncologist. We present descriptive statistics and a multiple linear regression model to identify factors independently associated with QOL domain score. Results: 270 respondents identified as MIBC patients. Among MIBC respondents, 38% were female and 97% were white. The mean age was 67.4 years (range 30 to 93 years). Respondents were highly educated (67% completed college). Among MIBC patients, 17% sought care from a general urologist only, 33% from a urologic oncologist only, and 50% from a multidisciplinary team that included either a medical or radiation oncologist. Physician specialty was not associated with generic, sexual, or bowel QOL. Patients seeing a general urologist had—on average—better urinary function compared with those seeing a urologic oncologist or multidisciplinary team. On multivariable analysis, physician specialty remained a significant predictor of urinary function (p = 0.02), controlling for age, sex, race, recurrence, and comorbidity. Conclusions: Among MIBC patients, physician specialty does not substantially impact general QOL but may be associated with urinary function. This may relate to cancer severity or other unmeasured patient characteristics.