Login to Access Video or Poster Abstract: MP69-13
Sources of Funding: Florida Bankhead-Coley Research Program

Introduction

Prior quality of life (QOL) research in bladder cancer has predominantly focused on differences between patients treated with radical cystectomy (RC) and different forms of urinary diversion. Other aspects of bladder cancer treatment, such as receipt of neoadjuvant chemotherapy (NAC), have gone unexamined. Using validated health questionnaires, we sought to determine the relationship between receipt of NAC and patient QOL.

Methods

124 patients were enrolled in a prospective complication and QOL assessment study between 2013 and 2015. Patients were surveyed longitudinally with a panel of health questionnaires, including the SF-36, a measure of general quality of life. The SF-36 contains 36 questions that assess several health domains, including physical functioning, physical health problems, pain, general health perception, emotional well-being, emotional health problems, social functioning and energy/fatigue. Patients surveyed in this study completed the SF-36 prior to cystectomy and at 3, 6 and 12-months following RC. Generalized linear models were used to examine differences in SF-36 scores by the primary exposure of interest (receipt of NAC) and adjusted for clinical and demographic factors.

Results

87 patients completed the SF-36 at both baseline and 6 months. The mean age was 68 years and 66 (75.8%) were men. More than half (46, 52.9%) received NAC. Patients who were not treated with NAC had lower SF-36 scores 6 months after RC (change in physical composite score (PCS) -1.47 vs. +1.95 and mental composite score (MCS) -1.96 vs. +3.68) compared to those who did. After adjusting for age, gender, diversion type and stage, receipt of NAC was significantly associated with higher general health perceptions (PE 5.29, p=0.012), emotional well-being (PE 5.41, p=0.012), and mental composite score (PE 6.02, p=0.005). There was no difference with NAC in PCS after controlling for confounders (p=0.10).

Conclusions

Receipt of NAC is a significant predictor of better quality of life 6 months after cystectomy as measured by SF-36. We found significant differences between patients treated with and without NAC in several domains, including mental composite score, general health perception, and emotional well-being. The exact mediators of this association need to be examined in larger studies.

Funding

Florida Bankhead-Coley Research Program