Department of Urology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Indiana School of Medicine, Indianapolis, IN.
Urol Oncol. 2023 Jun;41(6):293.e15-293.e21. doi: 10.1016/j.urolonc.2023.01.020. Epub 2023 Mar 27.
To describe the impact of bladder-preserving treatment vs. cystectomy on work productivity and activity impairment (WPAI) among patients with bladder cancer.
Using cross-sectional survey data, we constructed 2-part models involving both logistic and linear prediction to describe the relationship between WPAI and treatment modality among patients with non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC).
A total of 848 patients were included in the analysis. Patients with NMIBC who had cystectomy were more likely to experience activity impairment compared with those receiving bladder-preserving treatment (OR: 4.25, 95% CI: 2.28-7.93). Among patients with MIBC, cystectomy was protective against increasing presenteeism (e^β: 0.41, 95% CI: 0.23-0.71) and productivity loss (e^β: 0.44, 95% CI: 0.21-0.88); however, the opposite effect was seen for absenteeism treatment (e^β: 4.82, 95% CI: 1.72-13.49).
Cystectomy increased the odds of experiencing activity impairment for patients with NMIBC. However, for patients with MIBC, cystectomy appears to be protective for presenteeism and productivity loss. Further work is needed in order to better understand these important relationships and improve both patient counseling and shared decision-making.
描述保留膀胱治疗与膀胱切除术对膀胱癌患者工作生产力和活动障碍（WPAI）的影响。
使用横断面调查数据，我们构建了包含逻辑和线性预测的两部分模型，以描述非肌肉浸润性膀胱癌（NMIBC）和肌肉浸润性膀胱癌（MIBC）患者的 WPAI 与治疗方式之间的关系。
共纳入 848 例患者进行分析。接受膀胱切除术的 NMIBC 患者比接受保留膀胱治疗的患者更有可能出现活动障碍（OR：4.25，95%CI：2.28-7.93）。对于 MIBC 患者，膀胱切除术可预防生产力下降（e^β：0.41，95%CI：0.23-0.71）和生产力损失（e^β：0.44，95%CI：0.21-0.88）；然而，对于缺勤治疗，情况则相反（e^β：4.82，95%CI：1.72-13.49）。
膀胱切除术增加了 NMIBC 患者发生活动障碍的几率。然而，对于 MIBC 患者，膀胱切除术似乎对生产力下降和缺勤有保护作用。需要进一步研究以更好地理解这些重要关系，并改善患者咨询和共同决策。
