Measuring health-related quality of life outcomes in bladder cancer patients using the Bladder Cancer Index (BCI).
BACKGROUND
Health-related quality of life (HRQOL) has not been adequately measured in bladder cancer. A recently developed reliable and disease-specific quality of life instrument (Bladder Cancer Index, BCI) was used to measure urinary, sexual, and bowel function and bother domains in patients with bladder cancer managed with several different interventions, including cystectomy and endoscopic-based procedures.


METHODS
Patients with bladder cancer were identified from a prospective bladder cancer outcomes database and contacted as part of an Institutional Review Board-approved study to assess treatment impact on HRQOL. HRQOL was measured using the BCI across stratified treatment groups. Bivariate and multivariable analyses adjusted for age, gender, income, education, relationship status, and follow-up time were performed to compare urinary, bowel, and sexual domains between treatment groups.


RESULTS
In all, 315 bladder cancer patients treated at the University of Michigan completed the BCI in 2004. Significant differences were seen in mean BCI function and bother scores between cystectomy and native bladder treatment groups. In addition, urinary function scores were significantly lower among cystectomy patients treated with continent neobladder compared with those treated with ileal conduit (all pairwise P<.05).


CONCLUSIONS
The BCI is responsive to functional and bother differences in patients with bladder cancer treated with different surgical approaches. Significant differences between therapy groups in each of the urinary, bowel, and sexual domains exist. Among patients treated with orthotopic continent urinary diversion, functional impairments related to urinary incontinence and lack of urinary control account for the low observed urinary function scores.
Gilbert
Scott M
SM
Department of Urology, Division of Health Services Research, University of Michigan, Ann Arbor, Michigan 48109-0759, USA.
Wood
David P
DP
Dunn
Rodney L
RL
Weizer
Alon Z
AZ
Lee
Cheryl T
CT
Montie
James E
JE
Wei
John T
JT
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D015653:Cystectomy / Q000009:adverse effects; D003558:Cystoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000523:psychology* / Q000628:therapy*; D014547:Urinary Diversion / Q000009:adverse effects; D014549:Urinary Incontinence / Q000209:etiology
D000970:Antineoplastic Agents