ASSESSMENT OF QUALITY-OF-LIFE AFTER CYSTECTOMY OR CONSERVATIVE THERAPY FOR PATIENTS WITH INFILTRATING BLADDER-CARCINOMA - A SURVEY BY A SELF-ADMINISTERED QUESTIONNAIRE

BAGKGROUND. Quality of life (QOL) has rarely been assessed in nonmetas tatic bladder cancer patients (NMBC). Therefore, very little informati on is available for comparing the impact of different treatments on QO L for patients affected by NMBC. METHODS. We developed an ''ad hoc'' s elf-administered questionnaire and evaluated its psychometric properti es. We then carried out a retrospective study by mailing the questionn aire to a consecutive series of 93 patients treated for NMBC between 1 981 and 1994. The patients were treated either with a conservative app roach (CT), based on radiotherapy with or without chemotherapy, or wit h cystectomy followed by urostomy (US). RESULTS. Twenty-nine questionn aires (66%) mailed to conservatively treated patients and 30 (61%)-mai led to-cystectomized patients were returned. The questionnaire used in the study showed sufficient psychometric properties: an alpha-Cronbac h coefficient > 0.8 M as reached and validity was established in all o f its aspects. The items were grouped into seven subscales reflecting different QOL domains. The two treatment groups reported differences i n QOL adjustment. QOL after cystectomy, marked by stoma presence, was reduced by a lack of sexual activity and a worsened physical condition , but social and recreational life were little affected. Conversely, a low incidence of urinary symptoms and an acceptable sexual adjustment were found in the CT sample; the physical, psychologic, and sociorela tional adjustments were also good. QOL in the CT group was consistentl y better than in the US group. AU subscale scores were higher in the C T group than in the US group, with a statistically significant differe nce in four of six subscales. CONCLUSIONS. QOL is better after conserv ative therapy than after cystectomy, as expected. Prospective studies with repeated measurements covering all fields of interest in QOL woul d offer an accurate assessment of QOL in NMBC patients. Cancer 1996; 7 8:1089-97. (C) 1996 American Cancer Society.