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  • Review Article
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Health-related quality of life after curative treatment for muscle-invasive bladder cancer

Nature Reviews Urology volume 20, pages 279–293 (2023)Cite this article

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Abstract

Muscle-invasive bladder cancer (MIBC) is an aggressive disease for which the gold-standard treatment is radical cystectomy (RC) in combination with cisplatin-based neoadjuvant chemotherapy. Bladder-sparing strategies such as trimodal therapy (TMT) have also emerged to improve health-related quality of life (HRQoL) of patients. However, an improved understanding of the effect of all these treatment modalities on HRQoL is essential to provide personalized patient care. Different combinations of generic, cancer-specific and bladder cancer-specific questionnaires can be used as instruments for HRQoL evaluation in patients with MIBC before and after curative treatments, which can largely affect multiple domains of HRQoL including general health as well as physical, functional, social and emotional well-being. However, diagnosis of MIBC per se is also likely to affect HRQoL, and the perspective of cure after RC or TMT could induce a return to baseline HRQoL values for most of these domains. A considerable amount of data on HRQoL after RC is available, but conflicting results have been reported regarding the effect of urinary diversion (ileal conduit or orthotopic neobladder) and surgical approach (open or robotic surgery) on patient quality of life. Data on HRQoL after TMT are scarce, and additional comparative studies including patients receiving RC (especially using ileal orthotopic neobladder) are needed.

Key points

  • A combination of generic, cancer-specific and bladder cancer-specific questionnaires should be used to evaluate health-related quality of life (HRQoL) in patients with muscle-invasive bladder cancer before and after curative treatment.

  • Treatment of muscle-invasive bladder cancer can affect many domains of HRQoL (physical, functional, social and emotional well-being), but a return to baseline values is possible.

  • A high amount of data on HRQoL after radical cystectomy is available, but inconsistent results have been reported regarding the superiority of any urinary diversion type (ileal conduit or orthotopic neobladder) or surgical approach (open or robotic).

  • Data on HRQoL after trimodal therapy are scarce, and comparative studies with increased follow-up times are needed.

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Fig. 1: Proportions of studies evaluating HRQoL after RC and TMT.

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Authors and Affiliations

  1. Sorbonne University, GRC 5, Predictive Onco-Urology, APHP, Pitié-Salpêtrière Hospital, Urology, Paris, France

    Elisabeth Grobet-Jeandin, Ugo Pinar, Jérôme Parra, Morgan Rouprêt & Thomas Seisen

  2. Division of Urology, Geneva University Hospitals, Geneva, Switzerland

    Elisabeth Grobet-Jeandin

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E.G.-J., U.P. and T.S. researched data for the article. All authors contributed substantially to discussion of the content. E.G.-J. and U.P. wrote the article. J.P., M.R. and T.S. reviewed and edited the manuscript before submission.

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Nature Reviews Urology thanks J. Teoh, G. Kulkarni, who co-reviewed with K. McAlpine and the other, anonymous, reviewers for their contribution to the peer review of this work.

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Grobet-Jeandin, E., Pinar, U., Parra, J. et al. Health-related quality of life after curative treatment for muscle-invasive bladder cancer. Nat Rev Urol 20, 279–293 (2023). https://doi.org/10.1038/s41585-022-00693-z

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