Utility of Patient-Reported Symptom and Functional Outcomes to Indicate Recovery after First 90 Days of Radical Cystectomy: A Longitudinal Study
Author:
Wang Xin Shelley1, Bree Kelly K.2, Navai Neema2, Kamal Mona1ORCID, Shen Shu-En1ORCID, Letona Elizabeth1, Cleeland Charles S.1, Shi Qiuling3, Gottumukkala Vijaya4
Affiliation:
1. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA 2. Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA 3. School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China 4. Department of Anesthesiology & Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Abstract
This is a longitudinal prospective study that tracked multiple symptom burden and functioning status for bladder cancer (BLC) patients for 3 months post-radical cystectomy at The University of Texas MD Anderson Cancer Center, using a validated disease-specific patient-reported outcome measure (PROM) tool, the MD Anderson Symptom Inventory (the MDASI-PeriOp-BLC). The feasibility of collecting an objective measure for physical functioning, using “Timed Up & Go test” (TUGT) and PRO scores at baseline, discharge and end of study, was tested. Patients (n = 52) received care under an ERAS pathway. The more severe scores of fatigue, sleep disturbance, distress, drowsiness, frequent urination and urinary urgency at baseline predicted poor functional recovery postoperatively (OR = 1.661, 1.039–2.655, p = 0.034); other more severe symptoms at discharge (pain, fatigue, sleep disturbance, lack of appetite, drowsiness, bloating/abdominal tightness) predicted poor functional recovery (OR = 1.697, 1.114–2.584, p = 0.014) postoperatively. Compliance rates at preoperative, discharge and end of study were 100%, 79% and 77%, while TUGT completion rates were 88%, 54% and 13%, respectively. This prospective study found that more severe symptom burden at baseline and discharge is associated with poor functional recovery post-radical cystectomy for BLC. The collection of PROs is more feasible than using performance measures (TUGT) of function following radical cystectomy.
Funder
National Institutes of Health/National Cancer Institute
Subject
Cancer Research,Oncology
Reference36 articles.
1. Neoadjuvant Chemotherapy plus Cystectomy Compared with Cystectomy Alone for Locally Advanced Bladder Cancer;Grossman;N. Engl. J. Med.,2003 2. NCCN (2019, January 01). NCCN Clinical Practice Guidelines in Oncology-Bladder Cancer, Version 3.2019. Available online: https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. 3. Vashistha, V., Quinn, D.I., Dorff, T.B., and Daneshmand, S. (2014). Current and recent clinical trials for perioperative systemic therapy for muscle invasive bladder cancer: A systematic review. BMC Cancer, 14. 4. Validation and application of a module of the MD Anderson Symptom Inventory for measuring perioperative symptom burden in patients with gynecologic cancer (the MDASI-PeriOp-GYN);Wang;Gynecol. Oncol.,2019 5. Van Hemelrijck, M., Sparano, F., Josephs, D., Sprangers, M., Cottone, F., and Efficace, F. (2019). Patient-reported outcomes in randomised clinical trials of bladder cancer: An updated systematic review. BMC Urol., 19.
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