根治性膀胱切除术后膀胱癌治疗晚期效应对生活质量的影响：一项病例对照研究。
Impact of late effects after treatment for bladder cancer with radical cystectomy on Quality of life: a case-control study.
作者信息
Milling Rikke V, Nielsen Ninna K, Graugaard-Jensen Charlotte, Christensen Peter, Pappot Helle, Jensen Jørgen B
机构信息
Aarhus University Hospital, Department of Urology, Aarhus, Denmark; Aarhus University, Department of Clinical Medicine, Aarhus, Denmark.
Aarhus University, Department of Clinical Medicine, Aarhus, Denmark; Aarhus University Hospital, Department of Surgery, Aarhus, Denmark.
出版信息
Acta Oncol. 2025 Jan 8;64:27-33. doi: 10.2340/1651-226X.2025.41040.
BACKGROUND AND PURPOSE
The gold standard when treating muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC), a procedure that holds the potential to affect the function of several pelvic organs, causing an impact on the patient's Quality of Life (QoL). Knowledge of the late effects following bladder cancer and treatment with RC is sparse. The aim is to describe the incidence of late effects and to investigate the impact on QoL.
METHODS
A cross-sectional study using register data in combination with a questionnaire, measuring pelvic organ specific symptoms to treatment and QoL. MIBC patients diagnosed between 2015 and 2020 and able to receive digital mail was invited. For each MIBC patient, 6 age- and gender matched controls were invited. QoL was measured using EORTC-QLQ-C30. The MIBC specific EORTC-QLQ-BLM30 was administered to cases only.
BACKGROUND AND PURPOSE
The gold standard when treating muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC), a procedure that holds the potential to affect the function of several pelvic organs, causing an impact on the patient's Quality of Life (QoL). Knowledge of the late effects following bladder cancer and treatment with RC is sparse. The aim is to describe the incidence of late effects and to investigate the impact on QoL.
METHODS
A cross-sectional study using register data in combination with a questionnaire, measuring pelvic organ specific symptoms to treatment and QoL. MIBC patients diagnosed between 2015 and 2020 and able to receive digital mail was invited. For each MIBC patient, 6 age- and gender matched controls were invited. QoL was measured using EORTC-QLQ-C30. The MIBC specific EORTC-QLQ-BLM30 was administered to cases only.
RESULTS
A total of 628 (54.3%) MIBC patients and their 1,204 (37.3%) matched controls responded. Median age was 73. Mean time since RC was 4.9 (SD 2.1) years. Scoring of the functional items on EORTC-QLQ-C30 and overall QoL were similar for cases and controls. Regarding late effects, similar responses were seen on questionnaire data when comparing cases and controls. On registry data, a higher risk of infections and hydronephrosis were seen for cases. A strong correlation between fatigue and impaired QoL was identified.
INTERPRETATION
MIBC patients were more often diagnosed with late effects such as infections and hydronephrosis, compared to controls. In spite of this, MIBC patients overall QoL was equal to that of the controls.
背景与目的
治疗肌层浸润性膀胱癌（MIBC）的金标准是根治性膀胱切除术（RC），该手术有可能影响多个盆腔器官的功能，进而对患者的生活质量（QoL）产生影响。关于膀胱癌及RC治疗后的远期影响的了解较为匮乏。本研究旨在描述远期影响的发生率，并调查其对生活质量的影响。
方法
采用横断面研究，结合登记数据与问卷调查，评估盆腔器官特定的治疗相关症状及生活质量。邀请了2015年至2020年间确诊且能够接收电子邮件的MIBC患者。为每位MIBC患者邀请6名年龄和性别匹配的对照者。使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC-QLQ-C30）评估生活质量。仅对MIBC患者组施用MIBC特异性的欧洲癌症研究与治疗组织膀胱癌问卷（EORTC-QLQ-BLM30）。
结果
共有628名（54.3%）MIBC患者及其1204名（37.3%）匹配的对照者做出了回应。中位年龄为73岁。自RC手术以来的平均时间为4.9（标准差2.1）年。MIBC患者组和对照组在EORTC-QLQ-C30功能项目得分及总体生活质量方面相似。关于远期影响，比较患者组和对照组的问卷数据时，得到了相似的回答。在登记数据方面，患者组出现感染和肾积水的风险更高。研究发现疲劳与生活质量受损之间存在强相关性。
解读
与对照组相比，MIBC患者更常被诊断出患有感染和肾积水等远期影响。尽管如此，MIBC患者的总体生活质量与对照组相当。
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