PD44-03: Evaluation of gender specific differences in health-related quality of life for bladder cancer patients after radical cystectomy - Results from a large prospective propensity score-matched cohort
Introduction: Previous studies have shown gender specific differences in diagnosis and oncologic outcome for patients with bladder cancer (BC). However, in BC patients, gender specific differences in health-related quality of life (HRQOL) outcomes following radical cystectomy (RC) remain unclear. We aimed to assess gender specific differences in HRQOL by providing data from a large prospective propensity score (PS)-matched cohort of patients undergoing RC with a systematic follow-up of up to 10 yrs. Methods: 1498 consecutive BC patients [n=421 female, n=1077 male] who underwent RC at a large tertiary care center were included. PS-matching of 794 patients [n=397 women, n=397 men] was conducted applying matching variables “age at RC”, “BMI”, “pT-stage” and “type of urinary diversion. HRQOL was assessed systematically, applying EORTC QLQ-C30- as well as the bladder cancer-specific QLQ-BLM30- and FACT-BL-questionnaires. Separate modeling of longitudinal HRQOL for women and men was performed. Spearman’s rank correlation was applied to identify gender specific factors influencing HRQOL. Results: At baseline, female and male patients showed no difference in general HRQOL assessed by the global health status domain (GHS) (p=.162). In longitudinal analysis, a similar course of GHS for women and men was observed till 36mo after RC (p-range: .107 - .856). Between 48mo and 96mo after RC, GHS was significantly better for males (p-range: .002-.045). Spearman’s rank correlation revealed a significant correlation between physical functioning or urinary continence and increased general HRQOL equally for male and female patients (each p< .05). No correlation was found between sexual functioning and increased general HRQOL. While a strong correlation between Social/Family wellbeing and increased general HRQOL was found for women (p=.001), no correlation was shown for male patients (p=.103). Conclusions: The current study provides prospective data from a large propensity score-matched contemporary patient cohort, which displays gender specific differences in the natural course of general HRQOL and its subdomains. These data might play an important role in guiding gender specific treatment decision-making for patients with BC. SOURCE OF Funding: none
