Quality of life and psychological adaptation after surgical treatment for localized renal cell carcinoma: Impact of the amount of remaining renal tissue

Objectives. To analyze the quality of life and psychological adjustment aft er surgical therapy for localized renal cell carcinoma. Methods. Postal questionnaires including measures of quality of life (SF-36 ) and the impact of the stress of cancer (Impact of Events Scale) were comp leted by 97 patients who had undergone radical or partial nephrectomy for l ocalized renal cell carcinoma. Data were analyzed for the group as a, whole and comparing the partial nephrectomy and radical nephrectomy groups. The variables examined included the impact of the type of partial nephrectomy ( elective versus mandatory) and the amount of self-reported renal tissue rem aining. Results. The quality of life for the group as a whole was good, with no sig nificant differences between the sample and U.S. norms for an age and sex-m atched community sample on both the mental and physical health composite sc ores. Having undergone a partial versus a radical nephrectomy did not influ ence the patients' overall quality of life. Multiple linear regression mode ling demonstrated that having more remaining renal parenchyma was an indepe ndent predictor of better self-reported physical health on the SF-36 (P < 0 .001). The entire sample had low mean scores on both avoidance and intrusio n on the Impact of Events Scale, suggesting a lack of daily anxiety about c ancer. Multiple linear regression modeling showed that patients who reporte d having more remaining renal parenchyma had lower intrusion and avoidance scores (P = 0.002 and 0.01, respectively). Multiple logistic regression mod eling also demonstrated that the patients' perception of their remaining re nal parenchyma was associated with less concern about cancer recurrence (P = 0.018) and less impact of cancer on patients' overall health (P < 0.001). Conclusions. Most survivors of localized kidney cancer have normal physical and mental health regardless of the type of nephrectomy performed. The qua lity of life is better for patients with more renal parenchyma remaining af ter surgery for localized renal cell carcinoma. UROLOGY 57: 252-256, 2001. (C) 2001, Elsevier Science Inc.