Volz Yannic, Eismann Lennert, Westhofen Thilo, Pyrgidis Nikolaos, Pfitzinger Paulo L, Hermans Julian, Ebner Benedikt, Jokisch Jan-Friedrich, Weinhold Philipp, Bischoff Robert, Chaloupka Michael, Keller Patrick, Buchner Alexander, Schulz Gerald B, Stief Christian G, Marcon Julian
Department of Urology, University Hospital of the LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
World J Urol. 2025 Aug 25;43(1):512. doi: 10.1007/s00345-025-05876-y.
To investigate the prognostic significance of preoperative health-related quality of life (HRQOL) functioning scores, assessed by the EORTC QLQ-C30 questionnaire, in predicting survival outcomes for patients undergoing radical cystectomy (RC) for urothelial carcinoma (UC) of the bladder. While established prognostic factors include tumor stage and lymph node involvement, the role of HRQOL in survival remains underexplored.
We retrospectively analyzed patients who underwent RC for bladder cancer at a tertiary center between April 2013 and August 2024. Preoperative HRQOL domains-physical (PF), role (RF), and emotional functioning (EF)-were assessed using the EORTC QLQ-C30 questionnaire. Patients were stratified based on PF scores (≥ 90 vs. <90), and propensity score matching was applied. Survival outcomes, including overall survival (OS) and recurrence-free survival (RFS), were analyzed using Kaplan-Meier estimates and Cox regression models.
Overall, 276 patients were included. Patients with PF scores ≥ 90 had significantly higher 5-year OS (80.4% vs. 55.5%, p = 0.003) and lower recurrence rates. Low PF scores were an independent predictor of worse OS (HR: 2.54, 95% CI 1.42-4.55, p = 0.002). RF scores also influenced OS, while EF scores showed no association with survival.
Preoperative PF and RF scores provide valuable prognostic information for patients undergoing RC. Given the modifiable nature of PF, prehabilitation programs could improve outcomes. Integrating HRQOL assessments into routine preoperative evaluations may enhance personalized risk stratification and patient care.
通过欧洲癌症研究与治疗组织（EORTC）QLQ-C30问卷评估术前健康相关生活质量（HRQOL）功能评分，以探讨其对接受根治性膀胱切除术（RC）治疗膀胱尿路上皮癌（UC）患者生存结局的预后意义。虽然既定的预后因素包括肿瘤分期和淋巴结受累情况，但HRQOL在生存方面的作用仍未得到充分研究。
我们回顾性分析了2013年4月至2024年8月在一家三级中心接受膀胱癌RC手术的患者。使用EORTC QLQ-C30问卷评估术前HRQOL领域——身体功能（PF）、角色功能（RF）和情绪功能（EF）。根据PF评分（≥90分与<90分）对患者进行分层，并应用倾向得分匹配。使用Kaplan-Meier估计法和Cox回归模型分析生存结局，包括总生存期（OS）和无复发生存期（RFS）。
总共纳入了276例患者。PF评分≥90分的患者5年总生存率显著更高（80.4%对55.5%，p = 0.003），复发率更低。低PF评分是OS较差的独立预测因素（HR：2.54，95%CI 1.42 - 4.55，p = 0.002）。RF评分也影响OS，而EF评分与生存无关联。
术前PF和RF评分可为接受RC手术的患者提供有价值的预后信息。鉴于PF具有可改变的性质，术前康复计划可能会改善结局。将HRQOL评估纳入常规术前评估可能会加强个性化风险分层和患者护理。
