Long-term quality of life in patients with bladder cancer following radical cystectomy

To investigate changes in quality of life (QoL) up to 8 years after radical cystectomy (RC) and compare QoL after RC with a gender- and age-matched Dutch normative population. Furthermore, we aimed to identify patient characteristics associated with QoL and QoL trajectories after RC. Patients with bladder cancer were invited to complete QoL questionnaires at 3-month intervals in the first year and yearly thereafter. Follow-up data were available for a maximum of 8 years. We used linear mixed-effect models to investigate changes in QoL subscales (physical functioning [PF], emotional functioning [EF], and QoL summary score [QoL-sum]) over time, and to identify potential demographic and clinical correlates of QoL and QoL trajectories (i.e., interaction with time). Data from 278 patients was included. Post-RC EF scores increased from 83.7 (95% confidence interval [CI] 81.7-85.6) to levels comparable to the normative population (90.1) 8 years after RC. PF (post-RC: 82.4, 95% CI 78.5-86.3) and QoL-sum (post-RC: 88.2, 95% CI 85.2-91.2) remained lower compared to the normative population (88.9 and 91.4, respectively) 8 years after RC. Compared to patients with an American Society of Anesthesiologists (ASA) score of 1 at diagnosis, those with ASA score 2 or ASA score 3 had significant lower post-RC PF (mean difference (MD) = -8 and -22, respectively; P