Elsevier

Urology

Volume 65, Issue 2, February 2005, Pages 290-294
Urology

Adult urology
Impact of superficial bladder cancer and transurethral resection on general health-related quality of life: An SF-36 survey

https://doi.org/10.1016/j.urology.2004.09.050Get rights and content

Abstract

Objectives

To assess the general health-related quality of life (GHQOL) of patients with superficial bladder cancer who underwent transurethral resection (TUR).

Methods

We assessed the GHQOL a total of 178 times for 133 patients with superficial bladder cancer before multiple TURs. The GHQOL was assessed using the Medical Outcome Study Short-Form 36-item survey (SF-36). Ninety-three patients answered the questionnaire at the first TUR, 34 at the second TUR, 17 at the third TUR, and 34 at the fourth or later TUR.

Results

Compared with age-matched and sex-matched Japanese norms, the general health perception was severely impaired in patients with superficial bladder cancer. Their mental health was also severely impaired at the first TUR, but gradually returned to normal as TUR was repeated. The scores of physical functioning, social functioning, and role-emotional demonstrated a nadir at the second or third TUR, and increased thereafter if TUR was repeated four or more times. Intravesical treatment for prevention of recurrence increased the score of bodily pain.

Conclusions

Although superficial bladder cancer is not frequently lethal, patients with this disease believed their general health was much impaired. Only two domains of bodily pain and vitality had no negative impact from this disease. As urologists, we should notice the considerable affect of superficial bladder cancer on the GHQOL of patients.

Section snippets

Material and methods

From November 2000 to December 2003, 253 patients underwent a total of 403 TURs at our institution. Of these patients and TURs, those with benign tumors or invasive or metastatic bladder cancer requiring radical or palliative treatment other than TUR and those with prior nephroureterectomy or other treatment for upper urinary tract cancer were excluded from this study. Furthermore, patients older than 80 years were also excluded because of a lack of data in the SF-36 of Japanese normal

Results

The patient demographics are summarized in Table I. Of the 178 TURs enrolled in this study, 93 were the first procedure for primary tumors, 34 were the second, 17 were the third, and 34 were the fourth or later. Although no sex differences were found among the four groups, the patients who underwent the third or later TURs were older than those undergoing the first or second TURs (66.0 ± 9.7 years versus 70.1 ± 9.8 years, P = 0.008). No significant differences were found in the period from

Comment

Many studies have reported on the GHQOL of patients with bladder cancer.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 However, most of these dealt with postcystectomy status for invasive bladder cancer. It was reported in many studies that the type of urinary diversion did not affect GHQOL,3, 4, 6, 8, 10 but some reports suggested marginal9 or significant superiority of orthotopic neobladder or continent urinary diversion compared with ileal conduit in several domains.5, 7, 11 Although Fujisawa et al.6

Conclusions

In patients with superficial bladder cancer, the GH perception could be severely impaired throughout follow-up. Mental health was impaired most severely at the first TUR, and physical functioning, RP, role-emotional, and social function at the second or third TUR. Except for the GH perception, the scores of these domains returned to normal levels if patients underwent four or more TURs. Urologists should be aware of the considerable impact of superficial bladder cancer on the GHQOL of these

Acknowledgment

To Drs. Hiroki Ohara, Nobufimi Ueda, and Naoki Terada for their cooperation in this study.

References (17)

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