HRQOL Not Worse After TURBT for Bladder Cancer vs Radical Treatment

Health-related quality of life (HRQOL) did not appear changed or worsened in patients with bladder cancer after undergoing transurethral resection (TURBT), according to a recent study. However, radical treatment was associated with poor HRQOL outcomes. These study results were reported in the journal BJU International.

The study was a prospective analysis that included participants with newly diagnosed bladder cancer at UK National Health Service hospitals across multiple regions of the UK. HRQOL data were obtained from patients at 3-month intervals over a period of 12 months. These findings were compared with those from the Cancer Quality of Life Survey and Health Survey for England. Data in this analysis were derived from various questionnaires, including the EQ-5D, the EORTC QLQ-C30, the EORTC QLQ-NMIBC24, and the EORTC QLQ-BLM30.

A total of 349 participants were included. A baseline survey was completed by 85% of these patients, and 67% completed the final survey. The majority of patients (80%) had undergone TURBT with/without intravesical therapy, while 17% underwent radical treatment (cystectomy/radiotherapy), and 2% received palliation.

Baseline survey scores on EORTC QLQ-C30 showed that patients who required radical treatment had worse cancer-specific HRQOL than did patients undergoing TURBT. These included findings of lower social function (74.2 vs 83.8; P =.002), higher fatigue (31.5 vs 26.1; P =.03), and higher rates of more future worries (39.2 vs 29.4; P =.005). Patients undergoing radical treatment also reported greater anxiety/depression at baseline than did TURBT-treated patients (56% vs 36%; P =.03).

After treatment, participants who underwent TURBT reported improvements or no change in HRQOL outcomes. However, patients receiving radical treatment showed deterioration. 

Results from the final survey, considered to be during recovery, indicated some similarities with baseline scores for either cohort. Patients undergoing radical treatment indicated poorer HRQOL than TURBT-treated patients did, such as with poorer body image scores (23.4 vs 12.5; P =.007) and worse scores for male sexual function (75.8 vs 40.4; P <.001) on merged EORTC NMIBC24/BLM30 modules, in addition to worse scores on other metrics. 

EQ-5D utility scores were also lower for those receiving radical treatment than in the general population. These patients also reported having more problems with usual activities, compared with the general population.

The study investigators concluded that the study findings should provide reassurance to patients undergoing TURBT with/without intravesical therapy in terms of HRQOL impacts from treatment. “However, for those requiring radical treatment, a different picture has emerged that mandates clinical services to further develop the provision of symptom and supportive care to enhance their HRQOL,” the investigators wrote in their report.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Rogers Z, Glaser A, Catto JWF, et al. Quality of life after a diagnosis of bladder cancer: longitudinal survey over the first year. BJU Int. Published online November 29, 2023. doi:10.1111/bju.16242