Kennedy Lauren N, Miller Caleb S, May Danica N, Fruhauf Evan, Wyre Hadley W, Mirza Moben, Dai Junqiang, Holzbeierlein Jeffrey M, Stolzle Hayley, Mulhern Moira, Sardiu Mihaela E, Lee Eugene K
Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.
Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA.
Bladder Cancer. 2025 Apr 13;11(2):23523735251319180. doi: 10.1177/23523735251319180. eCollection 2025 Apr-Jun.
Radical cystectomy (RC) with urinary diversion (UD) is associated with substantial morbidity. Enhanced recovery after surgery protocols, increased robotic usage, and improvements in urinary diversion have been evaluated for their effects on health-related Quality of Life (HRQoL), however, results are mixed. How psychosocial traits inherent to the patient influence HRQoL outcomes is unknown in this population.
This study aimed to evaluate resilience and its correlation with HRQoL in a cohort of patients undergoing RC for bladder cancer.
Patients with bladder cancer undergoing RC with UD at the University of Kansas Medical Center were screened for prospective enrollment in this clinical trial (NCT06337305). The validated Connor-Davidson Resilience Scale 25 (CD-RISC), the Functional Assessment of Cancer Therapy-Bladder-Cystectomy (FACT-BL-Cys), and the PROMIS 29-v2.0 were administered preoperatively, 2-3 weeks postoperatively, and at 90 days postoperatively. Patient demographics, pathology, and complication data were collected.
Between November 2020 and August 2022, 52 patients completed the survey data. Patients were stratified based on baseline resilience score. The higher resilience group scored 85.7, 85.0, and 81.9 compared to 64.9, 70.4, and 72.0 at the three time points which all remained statistically significant. Participant resilience scores using the CD-RISC did not correlate with quality-of-life measures using the PROMIS or FACT-Bl-Cys at baseline or two weeks but did correlate at 90 days (p < 0.01). Resilience did not correlate with the patient's pathology stage or 90-day complication data.
Patients with higher baseline resilience maintain higher levels throughout the perioperative period and correlate with QOL.
根治性膀胱切除术（RC）联合尿流改道（UD）会带来较高的发病率。已对术后加速康复方案、机器人手术使用增加以及尿流改道的改进对健康相关生活质量（HRQoL）的影响进行了评估，然而，结果不一。在这一人群中，患者固有的心理社会特征如何影响HRQoL结果尚不清楚。
本研究旨在评估一组接受膀胱癌根治性膀胱切除术患者的心理韧性及其与HRQoL的相关性。
在堪萨斯大学医学中心接受RC联合UD的膀胱癌患者被筛选纳入该临床试验（NCT06337305）。在术前、术后2 - 3周和术后90天分别使用经过验证的康纳 - 戴维森心理韧性量表25（CD - RISC）、癌症治疗功能评估 - 膀胱 - 膀胱切除术（FACT - BL - Cys）和PROMIS 29 - v2.0进行评估。收集患者的人口统计学、病理学和并发症数据。
在2020年11月至2022年8月期间，52名患者完成了调查数据。患者根据基线心理韧性得分进行分层。心理韧性较高的组在三个时间点的得分分别为85.7、85.0和8l.9，而另一组在这三个时间点的得分分别为64.9、70.4和72.0，所有差异均具有统计学意义。使用CD - RISC的参与者心理韧性得分在基线或两周时与使用PROMIS或FACT - Bl - Cys的生活质量测量指标无相关性，但在90天时具有相关性（p < 0.01）。心理韧性与患者的病理分期或90天并发症数据无相关性。
基线心理韧性较高的患者在围手术期全程保持较高水平，且与生活质量相关。
