scholarly journals Quality of Life and Health State Utilities in Bladder Cancer

2021 ◽  
pp. 1-16
Author(s):  
Angela B. Smith ◽  
Sean McCabe ◽  
Allison M. Deal ◽  
Amy Guo ◽  
Kathryn H. Gessner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Metastatic Disease ◽  
Cost Effective ◽  
Health State ◽  
Financial Toxicity ◽  
Metastatic Bladder Cancer ◽  
Health State Utilities ◽  
Muscle Invasive

BACKGROUND: Bladder cancer treatments may variably impact health-related quality of life (QOL). OBJECTIVE: To characterize the quality of life of patients with bladder cancer at various time points across the continuum of bladder cancer care from non-muscle-invasive disease to metastatic bladder cancer and develop utility scores to inform cost-effective analyses. METHODS: We performed a cross-sectional survey of bladder cancer patients in the Bladder Cancer Advocacy Network Patient Survey Network. Participants were classified into mutually exclusive health states based upon non-muscle invasive (NMIBC), muscle-invasive (MIBC), or metastatic bladder cancer and completed surveys of generic cancer and bladder cancer-specific quality of life, financial toxicity, and work impairment. We constructed generalized linear mixed models to identify patient, clinical, and treatment factors associated with quality of life over time and derived health state utilities. RESULTS: Among 911 self-identified patients with bladder cancer, overall QOL scores and function domains were worse among those with advanced cancer. Financial toxicity was similar among non-metastatic disease states. Work and activity impairment increased with advancing disease (13%and 12%among non-recurrent NMIBC to 63%and 31%for metastatic disease respectively; p <  0.01). On multivariable analysis, bowel-related QOL was diminished among patients with MIBC, with urinary symptoms and physical function most diminished among patients with metastatic disease. Patients with metastatic and MIBC experienced worse emotional functioning (p = 0.04; p = 0.048). Health state utilities were calculated, highest among those with non-recurrent NMIBC and lowest among those with metastatic disease. CONCLUSION: Generic and bladder cancer-specific QOL diminishes with advancing disease. Health state utility estimates derived from this study can inform shared decision making with patients and may be used to inform future cost-effective analyses.

A phase II trial of risk-adapted treatment for muscle invasive bladder cancer after neoadjuvant accelerated MVAC.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. TPS537-TPS537 ◽  
Author(s):  
Daniel M. Geynisman ◽  
Philip Abbosh ◽  
Matthew R. Zibelman ◽  
Rebecca Feldman ◽  
David James McConkey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Bladder Cancer ◽  
Active Surveillance ◽  
Phase Ii ◽  
Standard Of Care ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

TPS537 Background: Cisplatin-based neoadjuvant chemotherapy (NAC) followed by cystectomy (Cx) or chemoradiation (CRT) is the standard of care for urothelial carcinoma (UC) pts with muscle invasive bladder cancer (MIBC). Both Cx and CRT carry potential short and long-term toxicity and quality of life implications. Recent work has shown that mutations in DNA damage repair/response genes are predictive of pathologic downstaging after NAC at the time of Cx, with those pts achieving pT0 disease demonstrating excellent long-term survival (Van Allen et al. Cancer Discov. 2014; Plimack et al. Eur Urol. 2015; Liu et al. JAMA Oncol. 2016; Teo et al. CCR. 2017). Sparing pts Cx or CRT after NAC without compromising oncologic outcomes would improve quality of life and decrease morbidity. Methods: A phase II, parallel arm, multi-institutional clinical trial (NCT02710734) is being conducted to evaluate a risk-adapted approach to treatment of MIBC. Pts with cT2-T3N0M0 UC of the bladder, ECOG PS 0-1 and CrCl≥50 mL/min, undergo NAC with accelerated methotrexate, vinblastine, doxorubicin, and cisplatin. Simultaneously, the pre-NAC TURBT specimen is submitted for deep sequencing to identify variants in a panel of cancer-relevant genes (Caris Life Sciences, Phoenix, AZ). Those with an alteration in ATM, RB1, FANCC or ERCC2 and no clinical evidence of disease by restaging TUR and imaging post-NAC will begin a pre-defined active surveillance regimen that includes urinary cytological, cystoscopic, and radiographic evaluations. The remaining pts will undergo bladder-directed therapy at the discretion of the pt and clinician applying either intravesical therapy ( < cT2 post-NAC), CRT or Cx (≤cT2 post-NAC) or Cx (≥cT3 post-NAC). The primary objective is metastasis-free survival (MFS) at 2 years for all enrolled and evaluable pts. The trial has a non-inferiority design with a 14% margin between risk-adapted treatment (MFS = 78%) and standard-of-care (MFS = 64%) with a sample size of 70 pts, 82% power and a type I error of 0.045. Key secondary and translational objectives: assess the rate of UC recurrence in active surveillance pts; validate biomarkers of response to NAC; evaluate urinary biomarkers consistent with persistent UC. Clinical trial information: NCT02710734.

MP86-05 THE RELATIONSHIP BETWEEN FINANCIAL TOXICITY AND QUALITY OF LIFE AMONG BLADDER CANCER PATIENTS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Marianne Casilla-Lennon ◽  
Seul Ki Cho ◽  
Allison Deal ◽  
Gopal Narang ◽  
Jeannette Bensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Financial Toxicity ◽  
The Relationship

scholarly journals Health State Utilities and Quality of Life in Patients with Hepatitis B

2012 ◽  
Vol 26 (7) ◽  
pp. 445-451 ◽  
Author(s):  
Gloria Woo ◽  
George Tomlinson ◽  
Colina Yim ◽  
Les Lilly ◽  
George Therapondos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hepatocellular Carcinoma ◽  
Standard Gamble ◽  
Antiviral Treatment ◽  
Decompensated Cirrhosis ◽  
Health State ◽  
Disease States ◽  
Compensated Cirrhosis ◽  
Health State Utilities

BACKGROUND: The effect of chronic hepatitis B (CHB) infection on health-related quality of life (HRQoL) and health state utilities has not been well characterized.OBJECTIVE: To measure utility scores and HRQoL across disease states associated with CHB infection.METHODS: Patients attending four tertiary care clinics for CHB were approached between July 2007 and March 2009. Respondents completed version 2 of the Short-Form 36 Health Survey, the EQ5D, a visual analogue scale, the Health Utilities Index Mark 3, standard gamble, and demographics and risk factor surveys in English, Cantonese or Mandarin. Charts were reviewed to determine disease stage and comorbidities.RESULTS: A total of 433 patients were studied: 294 had no cirrhosis; 79 had compensated cirrhosis; seven had decompensated cirrhosis; 23 had hepatocellular carcinoma; and 30 had received a liver transplant. The mean standard gamble utilities for these disease states were 0.89, 0.87, 0.82, 0.84 and 0.86, respectively. HRQoL scores in noncirrhotic patients were similar to those of the general population. Scores of patients with compensated cirrhosis were not significantly lower; however, patients with decompensated cirrhosis and hepatocellular carcinoma had significantly lower HRQoL scores compared with noncirrhotic patients (P<0.05). Similar scores were observed among patients on and off oral antiviral treatment. Post-liver transplant patients had a higher HRQoL than patients with decompensated cirrhosis. Age, number of comorbidities and relationship status were significantly associated with HRQoL scores.CONCLUSIONS: HRQoL in CHB patients is only impaired in the later stages of liver disease. Neither CHB infection nor antiviral treatment is associated with a lower quality of life.

scholarly journals Quality of life and anxiety in patients with non-muscle invasive bladder cancer: a prospective study

2020 ◽  
Author(s):  
Alexandros Vaioulis ◽  
Konstantinos Bonotis ◽  
Konstantinos Perivoliotis ◽  
Yiannis Kiouvrekis ◽  
Stavros Gavras ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Bladder Cancer ◽  
The State ◽  
Invasive Bladder Cancer ◽  
Physical And Mental Health ◽  
Muscle Invasive Bladder Cancer ◽  
Sf 36 ◽  
Muscle Invasive

Introduction We evaluated anxiety and quality of life (QoL) in patients who were operated for non-muscle invasive bladder cancer (NMIBC) Methods The present study is a prospective analysis of patients with histopathologically confirmed NMIBCs after they were submitted to transurethral resection of the tumour (TURBT). Eligible were all adult patients with a single or multiple NMIBCs. All included patients followed therapy with either BCG or Epirubicin instillations. The SF-36 questionnaire Physical and Mental health aspects were used for QoL assessment. Similarly, the STAI-Y was introduced for the state (STAI-Y1) and trait anxiety (STAI-Y2) evaluation. Results In total, 117 eligible patients were included. Regarding SF-36 Physical a 6 months decrease was followed by an improvement at 12 months. Similarly, an increase of the SF-36 Mental health score was identified. In contrast to STAI-Y2, a long-term reduction of the state anxiety was identified. Preoperative SF-36 Physical was inversely correlated with age, while absence of alcohol was associated with lower mental health. Overall, patient characteristics, habits and the administered treatment did not affect the postoperative QoL and anxiety. Conclusions Patient QoL and anxiety improved during follow up. Although certain characteristics were related to QoL and anxiety, further larger scale studies are required.

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