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  • Review Article
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Quality-of-life assessment in patients with bladder cancer

Nature Clinical Practice Urology volume 4, pages 147–154 (2007)Cite this article

Abstract

Health-related quality of life (HRQOL) in patients with bladder cancer is important, because radical cystectomy and urinary diversion significantly affect urinary and sexual function, and lead to associated sex-specific morbidity. This article reviews the current methods for defining HRQOL, describes the specific challenges in measuring HRQOL in patients with bladder cancer, and critically analyzes the existing literature on bladder cancer HRQOL. Previous studies have been limited by study design, generalizability, and by the different instruments used, namely nonvalidated questionnaires that are not specific for bladder cancer. To date, only two prospective studies with baseline HRQOL data have been published and few conclusions can be drawn from these cross-sectional, retrospective studies. On the basis of the published literature, there is no convincing evidence that superior HRQOL is achieved with a particular type of urinary diversion after cystectomy for bladder cancer. Patients should be counseled on all reconstructive alternatives and a diversion chosen on the basis of patient preference, patient anatomy and tumor status, rather than on a potential difference in HRQOL. Prospective studies with appropriate adjustment for confounding factors, which use validated and disease-specific questionnaires, are needed for HRQOL research on bladder cancer.

Key Points

  • At present, there are no convincing data that a particular urinary diversion technique is associated with superior health-related quality of life (HRQOL) after cystectomy

  • Most published studies of HRQOL after cystectomy are limited by their cross-sectional, retrospective design and lack of baseline data

  • To capture the sex-specific effects on urinary and sexual function and levels of bother experienced by patients who have undergone cystectomy in a single questionnaire is a difficult task

  • The Functional Assessment of Cancer Therapy Bladder Cancer questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire for Muscle Invasive Bladder Cancer, and the Functional Assessment of Cancer Therapy—Vanderbilt Cystectomy Index are bladder-cancer-specific instruments that are currently being validated

  • Prospective studies with appropriate adjustment for confounding factors, and the use of validated and disease-specific questionnaires are needed in HRQOL research on bladder cancer

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Authors and Affiliations

  1. JL Wright is a Chief Resident in the Department of Urology at the University of Washington, and MP Porter is an Assistant Professor of Urology, and Adjunct Assistant Professor of Epidemiology at the University of Washington, VA Puget Sound Health Care System, Seattle, WA, USA.,

    Jonathan L Wright & Michael P Porter

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  1. Jonathan L Wright
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  2. Michael P Porter
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Correspondence to Michael P Porter.

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The authors declare no competing financial interests.

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Wright, J., Porter, M. Quality-of-life assessment in patients with bladder cancer. Nat Rev Urol 4, 147–154 (2007). https://doi.org/10.1038/ncpuro0750

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