Psycho-social well-being and general health status after surgical treatment for localized renal cell carcinoma.
OBJECTIVE
To comparatively assess the psychological, social well-being and general state of health in patients with stage 1 renal cell carcinoma (RCC) (according to 1997 TNM), who underwent either elective nephron sparing surgery (NSS) or radical nephrectomy.


METHODS
We evaluated the health-related quality of life (HR-QoL) in 88 patients who underwent radical nephrectomy and in 56 treated with elective NSS. The measurement of the main QoL components has been made using domain-specific questionnaires tested and validated in Italian language. Each questionnaire has been self-administrated during follow-up (cross-sectional study).


RESULTS
The two analysed group resulted perfectly comparable regarding age, gender, civil status, educational level, profession and mean follow-up. A low level anxiety has been documented in 11.4% of patients after radical nephrectomy and in 1.8% of those treated with an elective conservative surgery. The mean score difference between the two groups resulted statistically significant (p = 0.003). A mild depression has been recorded in 7% of patients who underwent radical nephrectomy and in 2.3% of NSS group. The mean score difference between the two groups was statistically significant (p = 0.01). The general health status was impaired in 12.5% of cases after radical nephrectomy and in 7% after elective NSS. Social problems were present in 18% of patients who underwent radical nephrectomy and in 18% of NSS group. There was no significant difference between radical and conservative group in terms of both General health Questionnaire and Social Problem Questionnaire mean scores.


CONCLUSIONS
HR-QoL in patients who underwent surgery for RCC is not particularly negatively affected. Nevertheless, the comparative analysis of the results showed that, at a long term follow-up, radical surgery seems to eventually cause a more relevant negative impact on the psychological well-being than conservative surgery.
Ficarra
Vincenzo
V
Department of Urology, University of Verona, Italy. vincenzoficarra@hotmail.com
Novella
Giovanni
G
Sarti
Alessandra
A
Novara
Giacomo
G
Galfano
Antonio
A
Cavalleri
Stefano
S
Artibani
Walter
W
D001007:Anxiety / Q000453:epidemiology; D002292:Carcinoma, Renal Cell / Q000523:psychology* / Q000601:surgery*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007680:Kidney Neoplasms / Q000523:psychology* / Q000601:surgery*; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods / Q000523:psychology; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires