Health‐related quality of life after bladder preservation therapy for muscle invasive bladder cancer

Hashine, Katsuyoshi; Miura, Noriyoshi; Numata, Kousaku; Shirato, Akitomi; Sumiyoshi, Yoshiteru; Kataoka, Makoto

doi:10.1111/j.1442-2042.2008.02032.x

Cited by 19 publications

(14 citation statements)

References 24 publications

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“…Nevertheless, the present analyses showed satisfactory results in terms of the maximum voided volume and post-void residual urine volume after treatment (median of 350 and 25 mL, respectively). The favourable SF-36 scores in this study suggest that patients maintained a high QoL after treatment with our selective tetramodal bladder-sparing therapy, which is consistent with the results of previous studies [8,[29][30][31].…”

Section: Discussionsupporting

confidence: 92%

Selective tetramodal bladder‐preservation therapy, incorporating induction chemoradiotherapy and consolidative partial cystectomy with pelvic lymph node dissection for muscle‐invasive bladder cancer: oncological and functional outcomes of 107 patients

et al. 2019

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Objectives To evaluate the oncological and functional outcomes associated with selective tetramodal bladder‐sparing therapy, comprising maximal transurethral resection of bladder tumour (TURBT), induction chemoradiotherapy (CRT), and consolidative partial cystectomy (PC) with pelvic lymph node dissection (PLND). Materials and Methods In the present study, 154 patients with non‐metastatic muscle‐invasive bladder cancer (MIBC), prospectively enrolled in the tetramodal bladder‐preservation protocol, were analysed. After TURBT and induction CRT, patients showing complete remission were offered consolidative PC with PLND for the achievement of bladder preservation. Pathological response to induction CRT was evaluated using PC specimens. Oncological and functional outcomes after bladder preservation were evaluated using the following endpoints: MIBC‐recurrence‐free survival (RFS); cancer‐specific survival (CSS); overall survival (OS), and cross‐sectional assessments of preserved bladder function and quality of life (QoL) including uroflowmetry, bladder diary, International Prostate Symptom Score, Overactive Bladder Symptom Score and the 36‐item Short‐Form Health Survey (SF‐36) score. Results The median follow‐up period was 48 months. Complete MIBC remission was achieved in 121 patients (79%) after CRT, and 107 patients (69%) completed the tetramodal bladder‐preservation protocol comprising consolidative PC with PLND. Pathological examination in these 107 patients revealed residual invasive cancer (≥pT1) that was surgically removed in 11 patients (10%) and lymph node metastases in two patients (2%). The 5‐year MIBC‐RFS, CSS and OS rates in the 107 patients who completed the protocol were 97%, 93% and 91%, respectively. As for preserved bladder function, the median maximum voided volume, post‐void residual urine volume, and nighttime frequency were 350 mL, 25 mL, and two voids, respectively. In the SF‐36, patients had favourable scores, equivalent to the age‐matched references in all the QoL scales. Conclusion Selective tetramodal bladder‐preservation therapy, incorporating consolidative PC with PLND, yielded favourable oncological and functional outcomes in patients with MIBC. Consolidative PC may have contributed to the low rate of MIBC recurrence in patients treated according to this protocol.

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Section: Discussionsupporting

confidence: 92%

Selective tetramodal bladder‐preservation therapy, incorporating induction chemoradiotherapy and consolidative partial cystectomy with pelvic lymph node dissection for muscle‐invasive bladder cancer: oncological and functional outcomes of 107 patients

et al. 2019

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“…[95][96][97] Healthrelated QoL of bladder-preserved MIBC patients treated with CRT was not significantly different from that of NMIBC patients treated conservatively. 98 In MIBC patients treated with PC after induction CRT, bladder capacity was transiently reduced to approximately 100 mL just after PC, but typically recovered to >300 mL within 6 months. A median IPSS of 33 patients treated with PC was 5, which is comparable with that of age-matched Japanese men.…”

Section: Toxicity Of Crt and Qolmentioning

confidence: 96%

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Koga

Kihara

2012

Int J of Urology

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Abbreviations & Acronyms BIS = bladder-intact survival CIS = carcinoma in situ CR = complete response CRT = chemoradiotherapy CSS = cancer-specific survival FU = fluorouracil GasLESS = gasless laparoendoscopic single-port surgery GC = gemcitabine, cisplatin HD = hemodialysis IAC = intra-arterial chemotherapy IMRT = intensity-modulated radiation therapy LCRT = low-dose chemoradiotherapy MCV = methotrexate, cisplatin and vinblastine MIBC = muscle-invasive bladder cancer MRI = magnetic resonance imaging MVAC = methotrexate, vinblastine, adriamycin and cisplatin NA = not available NFkB = nuclear factor kB NMIBC = non-muscle-invasive bladder cancer OS = overall survival PC = partial cystectomy PLND = pelvic lymph node dissection QoL = quality of life RC = radical cystectomy RTOC = Radiation Therapy Oncology Group SPARE = Selective bladder Preservation Against Radical Excision TMDU = Tokyo Medical and Dental University TURBT = transurethral resection of bladder tumors Abstract: Radical cystectomy plus urinary diversion, the reference standard treatment for muscle-invasive bladder cancer, associates with high complication rates and compromises quality of life as a result of long-term effects on urinary, gastrointestinal and sexual function, and changes in body image. As a society ages, the number of elderly patients unfit for radical cystectomy as a result of comorbidity will increase, and thus the demand for bladder-sparing approaches for muscle-invasive bladder cancer will also inevitably increase. Trimodality bladder-sparing approaches consisting of transurethral resection, chemotherapy and radiotherapy (S55-65 Gy) yield overall survival rates comparable with those of radical cystectomy series (50-70% at 5 years), while preserving the native bladder in 40-60% of muscle-invasive bladder cancer patients, contributing to an improvement in quality of life for such patients. Limitations of the trimodality therapy include (i) muscle-invasive bladder cancer recurrence in the preserved bladder, which most often arises in the original muscle-invasive bladder cancer site; (ii) potential lack of curative intervention for regional lymph nodes; and (iii) increased morbidity in the event of salvage radical cystectomy for remaining or recurrent disease as a result of high-dose pelvic irradiation. Consolidative partial cystectomy with pelvic lymph node dissection followed by induction chemoradiotherapy at lower dose (e.g. 40 Gy) is a rational strategy for overcoming such limitations by strengthening locoregional control and reducing radiation dosage. Molecular profiling of the tumor and functional imaging might play important roles in optimal patient selection for bladder preservation. Refinement of radiation techniques, intensified concurrent or adjuvant chemotherapy, and novel sensitizers, including molecular targeting agent, are also expected to improve outcomes and consequently provide more muscle-invasive bladder cancer patients with favorable quality of life.

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“…EPIC has been used to asses the impact of aging on domain-specific HRQOL 15, satisfaction and regret with prostatectomy 16, erectile dysfunction in patient treated with external beam radiation 17 and HRQOL among patients treated with bladder preservation therapy for muscle-invasive bladder cancer 18. Having been successfully used in the field by several investigative teams suggests the EPIC has robust construct validity.…”

Section: Commentmentioning

confidence: 99%

Development and Validation of an Abbreviated Version of the Expanded Prostate Cancer Index Composite Instrument for Measuring Health-related Quality of Life Among Prostate Cancer Survivors

Szymański

Wei

Dunn

et al. 2010

Urology

380

330

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Objectives-Widespread implementation of HRQOL measurement in prostate cancer practice and research requires concise instruments. Having 50 questions, the full-length Expanded Prostate cancer Index Composite (EPIC) is cumbersome to administer outside of studies focusing exclusively on HRQOL. To facilitate HRQOL measurement in a broad range of prostate cancer research and practice settings, we developed and validated an abbreviated version of EPIC.Methods-50 questions that comprise the full-length EPIC-50 were evaluated to identify items suitable for elimination while retaining ability to measure the 5 prostate cancer-specific HRQOL domains of EPIC-50. The resulting abbreviated version (EPIC-26) was validated using question responses from 252 subjects who had brachytherapy, external radiotherapy or prostatectomy for prostate cancer. EPIC-26 internal consistency was measured by Cronbach's alpha coefficient and reliability by test-retest correlation.Results-Based on high item-scale correlations, clinically relevant content, and preservation of domain psychometrics, 26 items were retained in EPIC-26 from 50 questions in the full length EPIC-50. High correlation was observed between EPIC-50 and EPIC-26 versions of urinary incontinence, urinary irritation/obstruction, bowel, sexual and vitality/hormonal domain scores (all r ≥0.96). Correlations between different domains were low, confirming that EPIC-26 retains the ability to discern 5 distinct HRQOL domains. Internal consistency and test-retest reliability for EPIC-26 (Cronbach's alpha ≥0.70 and r ≥ 0.69, respectively for all 5 HRQOL domains) support its validity.Conclusions-EPIC-26 is a brief, valid and reliable subjective measure of health quality among prostate cancer patients and suitable for measuring HRQOL among patients undergoing treatment for early stage prostate cancer.

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Health‐related quality of life after bladder preservation therapy for muscle invasive bladder cancer

Cited by 19 publications

References 24 publications

Selective tetramodal bladder‐preservation therapy, incorporating induction chemoradiotherapy and consolidative partial cystectomy with pelvic lymph node dissection for muscle‐invasive bladder cancer: oncological and functional outcomes of 107 patients

Selective tetramodal bladder‐preservation therapy, incorporating induction chemoradiotherapy and consolidative partial cystectomy with pelvic lymph node dissection for muscle‐invasive bladder cancer: oncological and functional outcomes of 107 patients

Selective bladder preservation with curative intent for muscle‐invasive bladder cancer: A contemporary review

Development and Validation of an Abbreviated Version of the Expanded Prostate Cancer Index Composite Instrument for Measuring Health-related Quality of Life Among Prostate Cancer Survivors

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