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非肌层浸润性膀胱癌患者对生活方式建议的依从性与健康相关生活质量的纵向关联

Longitudinal associations of adherence to lifestyle recommendations and health-related quality of life in patients with non-muscle invasive bladder cancer.

作者信息

Vidra Nikoletta, Beeren Ivy, van Zutphen Moniek, Aben Katja K, Kampman Ellen, Witjes J Alfred, van der Heijden Antoine G, Kiemeney Lambertus A, Vrieling Alina

机构信息

Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.

出版信息

Int J Cancer. 2023 May 15;152(10):2032-2042. doi: 10.1002/ijc.34418. Epub 2023 Jan 13.

Abstract

Although the role of lifestyle in health-related quality of life (HRQoL) outcomes has been increasingly recognized for various types of cancer, evidence in patients with non-muscle invasive bladder cancer (NMIBC) is very limited. We aimed to evaluate the longitudinal association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and HRQoL in patients with NMIBC. This study included 1029 patients with NMIBC recruited between May 2014 and April 2017 from the Dutch multi-centre prospective cohort study UroLife. Lifestyle and HRQoL data were collected at 6 weeks (baseline), 3 months and 15 months after diagnosis. Information on body mass index (BMI), physical activity, diet and alcohol was used to compute the standardized WCRF/AICR adherence score (0-7). HRQoL outcomes were evaluated by the EORTC QLQ-C30. Linear mixed models were used to assess longitudinal confounder-adjusted associations between the WCRF/AICR adherence score and HRQoL outcomes. Adherence to each additional WCRF/AICR recommendation was associated with better global quality of life, physical, role and social functioning, and less fatigue. We found stronger inter-individual than intra-individual associations, suggesting that associations were mainly driven by between-subject differences. Higher adherence to the BMI, physical activity and dietary recommendations was associated with better scores for most HRQoL outcomes, while adherence to the alcohol recommendation (ie, non-consumption) was associated with worse HRQoL. Following the WCRF/AICR lifestyle recommendations may improve HRQoL in patients with NMIBC. Intervention studies are needed to establish whether the association between lifestyle and HRQoL is causal.

摘要

尽管生活方式在各类癌症的健康相关生活质量(HRQoL)结果中的作用已得到越来越多的认可,但非肌肉浸润性膀胱癌(NMIBC)患者的相关证据却非常有限。我们旨在评估遵循2018年世界癌症研究基金会/美国癌症研究学会(WCRF/AICR)生活方式建议与NMIBC患者HRQoL之间的纵向关联。本研究纳入了1029例2014年5月至2017年4月间从荷兰多中心前瞻性队列研究UroLife招募的NMIBC患者。在诊断后的6周(基线)、3个月和15个月收集生活方式和HRQoL数据。利用体重指数(BMI)、身体活动、饮食和饮酒方面的信息计算标准化的WCRF/AICR遵循得分(0 - 7分)。通过欧洲癌症研究与治疗组织核心问卷(EORTC QLQ - C30)评估HRQoL结果。采用线性混合模型评估WCRF/AICR遵循得分与HRQoL结果之间经纵向混杂因素调整后的关联。遵循每一项额外的WCRF/AICR建议都与更好的总体生活质量、身体、角色和社会功能以及更少的疲劳相关。我们发现个体间的关联强于个体内的关联,这表明这些关联主要由个体间差异驱动。更高程度地遵循BMI、身体活动和饮食建议与大多数HRQoL结果的更好得分相关,而遵循饮酒建议(即不饮酒)则与更差的HRQoL相关。遵循WCRF/AICR生活方式建议可能会改善NMIBC患者的HRQoL。需要进行干预研究来确定生活方式与HRQoL之间的关联是否具有因果关系。

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