Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2765, USA.
Urology. 2012 Jul;80(1):77-83. doi: 10.1016/j.urology.2012.01.090. Epub 2012 May 18.
Radical cystectomy (RC) for bladder cancer can be associated with significant morbidity and alterations in health-related quality of life (HRQOL). The Functional Assessment of Cancer Therapy--Vanderbilt Cystectomy Index (FACT-VCI) is a condition-specific HRQOL survey for patients undergoing RC and urinary diversion (UD) for bladder cancer. This study evaluates the reliability, validity, and responsiveness of the Vanderbilt cystectomy index (VCI).
The FACT-VCI was administered to patients with bladder cancer undergoing RC and UD (n = 190) at 2 major cancer centers. Statistical methods included principal components analysis, Cronbach's coefficient alpha, and nonparametric correlation coefficients. The Functional Assessment of Cancer Therapy--General (FACT-G) was used to test criterion-related validity and a linear mixed model tested the effects of time and diversion type on longitudinal VCI scores.
A single summary score of 15 gender-neutral items (VCI-15) represented the optimum solution for postoperative data, which was internally consistent (α = 0.85), had strong retest reliability (ρ = 0.891), and was associated with all FACT-G scales and total score (ρ ≥ 0.38, P <.001). Preoperatively, the VCI-15 was internally consistent (α = 0.77) and was associated with the FACT-G physical and functional scales and total score (ρ ≥ 0.41, P <.001). Although VCI-15 scores at postoperative year 1 did not differ from preoperative values overall (P = .145), they did differ by diversion type (P = .027), with no substantive change after orthotopic neobladder (40 ± 9 vs 39 ± 10) but with a clinically significant improvement after an ileal conduit (39 ± 11 vs 44 ± 11).
The VCI-15 is a reliable and valid condition-specific HRQOL survey for patients with bladder cancer undergoing RC and UD. Future studies of RC patients should measure HRQOL using validated, condition-specific forms, such as the FACT-VCI.
膀胱癌根治性切除术（RC）可能会导致显著的发病率和生活质量相关变化（HRQOL）。癌症治疗功能评估 - 范德比尔特膀胱切除术指数（FACT-VCI）是一种针对接受 RC 和膀胱癌尿路改道（UD）的患者的特定于疾病的 HRQOL 调查。本研究评估了范德比尔特膀胱切除术指数（VCI）的可靠性、有效性和反应性。
在两个主要癌症中心，对接受 RC 和 UD 的膀胱癌患者（n=190）进行了 FACT-VCI 评估。统计方法包括主成分分析、克朗巴赫系数α和非参数相关系数。癌症治疗功能评估-一般（FACT-G）用于测试标准相关的有效性，线性混合模型测试了时间和改道类型对纵向 VCI 评分的影响。
15 个性别中立项目的单一综合评分（VCI-15）代表术后数据的最佳解决方案，该方案具有内部一致性（α=0.85），具有很强的重测可靠性（ρ=0.891），并与所有 FACT-G 量表和总分相关（ρ≥0.38，P<.001）。术前，VCI-15 具有内部一致性（α=0.77），与 FACT-G 生理和功能量表及总分相关（ρ≥0.41，P<.001）。尽管 VCI-15 在术后 1 年的评分总体上与术前值无差异（P=0.145），但它们确实因改道类型而异（P=0.027），在原位新膀胱后没有实质性变化（40±9 与 39±10），但在回肠导管后有临床显著改善（39±11 与 44±11）。
VCI-15 是一种可靠和有效的膀胱癌接受 RC 和 UD 的患者特定于疾病的 HRQOL 调查。未来对 RC 患者的研究应使用经过验证的特定于疾病的形式，如 FACT-VCI，来衡量 HRQOL。
