Quality of life studies and genito-urinary tumors

Background: Genitourinary (GU) tumors represent a large proportion of solid cancers (1 of 4) and a wide variety of natural histories, based on various prognostic factors and resulting in different treatment options and end po ints. In some cases, for the same stage of disease, different treatment str ategies do not impact differently on overall survival (OS): surgery vs. rad iation, or radical vs. conservative multidisciplinary approach, adjuvant or neoadjuvant, chemotherapy vs. BSC. Quality of life (QoL) is considered a r easonable end point when differences in OS do not seem to be striking. Design: A review of the literature on different disease stages was undertak en to show where and when QoL was used as the end point of treatment effica cy. Results: Very few studies have been performed in prostate, bladder and test icular cancer to show the impact of different treatment approaches on QoL. Although these studies might be considered as non-conclusive, some data may allow a better choice for the patients. Conclusions: QoL as the principal end point has not been used in clinical t rials of GU tumors comparing different treatment approaches. This makes the choice between treatments offering similar survival but different toxicity patterns, body and behavioral consequences more difficult. We suggest that future prospective randomized studies should be planned taking into accoun t the QoL as the main end point.