Introduction: As both screening and treatment of patients with muscle-invasive bladder cancer improve, the rate of cancer survivors will increase. Therefore, long term medical, psychological and social effects should be investigated. This study aims to investigate psycho-social distress and quality of life in German patients after radical cystectomy (RC). Methods: This study relied on prospectively collected data for patients, who underwent three weeks of inpatient rehabilitation after RC between April 2018 and December 2019. Data on psycho-social distress and quality of life were collected 4 weeks (T1), 6 months (T2) and 12 months (T3) post-surgery by validated instruments (QLQ-C30, QLQ-BLM, QSC-R10). Uni- and multivariate logistic regression was performed to identify predictors for high psycho-social distress. Results: 842 patients (683 male, 159 female) were included. 447 patients (326 male, 121 female) received an IC, 395 (357 male, 38 female; p<0.001) received an INB. Tumor stage =pT3a (41.4% vs 24.1%; p<0.001) and lymph node metastases (19.9% vs 11.8%; p<0.001) were significantly more often present in patients with an IC. Health related quality of life (HRQoL) did not differ between the cohorts and steadily improved during follow-up. At T2, social, emotional and cognitive function as well as future worries and body image worsened in patients only to improve again at T3 in all patients, but especially in patients with an INB. Overall, 34.9% of all patients reported high psycho-social distress (QSC-R10 =15) at T1. During follow-up, no significant difference in psychosocial distress between both cohorts was observed. However, at both T2 and T3, over 40% of all patients still reported high psycho-social distress. Univariate regression analysis identified lymph node metastases as a predictor for high psycho-social distress at T3 (OR 2,123; CI 1,194–3,777; p=0,010). Multivariate regression analysis revealed both age = 59 (OR 1,731; CI 1,056–2,838; p=0,030) and lymph node metastases (OR 2,073; CI 1,133–3,793; p=0,018) as predictors for high psycho-social distress at T3. Conclusions: Overall, HRQoL improves in all patients one year after RC. However, some sub-scales such as future worries, role function and emotional function still bother patients to varying degrees. A significant portion of both patients with an IC and an INB suffer from high psychosocial distress one year after RC. Especially young patients with lymph node metastases should be monitored regularly and undergo psychological counselling if necessary. SOURCE OF Funding: This study was funded by the “Nordrhein-Westfalen Association for the Fight Against Cancer, Germany.” The funder had no influence on the study design, data collection and analysis or preparation of the abstract.
