Abstract

BACKGROUND:

Bladder cancer (BC) is one of the most common malignancies (4.5%of all newly diagnosed cases worldwide). Most of the new BC cases are diagnosed as non-muscle invasive BC (NMIBC), needing continuous follow up after primary endoscopic therapy. Adjuvant bladder therapy with chemo- or immuno- agents, apart from the initial diagnosis, the strict surveillance program and the risk of recurrence, may have a major impact on the patients’ physical and mental health.

OBJECTIVE:

We evaluated anxiety and quality of life (QoL) in patients who underwent surgery for NMIBC and followed a bladder instillation programme.

METHODS:

This is a prospective analysis of patients with histopathologically confirmed NMIBCs. Eligible were all adult patients with a single or multiple NMIBCs who underwent a transurethral tumor resection and followed a therapy with either BCG or Epirubicin instillations. The SF-36 questionnaire Physical and Mental health aspects were used for QoL assessment. Similarly, the STAI-Y was introduced for the state (STAI-Y1) and trait anxiety (STAI-Y2) evaluation.

RESULTS:

117 eligible patients were screened, with 108 entering finally the study; 9 patients were excluded due to disease recurrence. 17 patients (15.7%) received Epirubicin (Ta-T1, Low Grade tumors), whereas 91 patients (84.3%) received BCG (T1, High Grade). Regarding SF-36 Physical a 6 months decrease was followed by an improvement at 12 months (p = 0.008). Similarly, an increase of the SF-36 Mental health score was identified (p = 0.03). In contrast to STAI-Y2 scores (p = 0.945), a long-term reduction of the state anxiety was identified (p = 0.001). Preoperative SF-36 Physical was inversely correlated with age (p = 0.029), while absence of alcohol was associated with lower mental health (p = 0.003). Overall, patient characteristics, habits and the administered treatment did not affect the postoperative QoL and anxiety.

CONCLUSION:

Patient QoL and anxiety improved during follow up. Still, further larger scale studies are required to support our findings.

中文翻译：

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首次诊断的非肌肉浸润性膀胱癌接受辅助膀胱治疗的患者的生活质量和焦虑

 抽象的

 背景：

膀胱癌 (BC) 是最常见的恶性肿瘤之一（占全球新诊断病例的 4.5%）。大多数新发 BC 病例被诊断为非肌层浸润性 BC (NMIBC)，初次内镜治疗后需要持续随访。使用化疗或免疫药物进行膀胱辅助治疗，除了初步诊断、严格的监测计划和复发风险外，可能对患者的身心健康产生重大影响。

 客观的：

我们评估了接受 NMIBC 手术并遵循膀胱灌注计划的患者的焦虑和生活质量 (QoL)。

 方法：

这是对经组织病理学证实的 NMIBC 患者的前瞻性分析。符合资格的是所有患有单个或多个 NMIBC 的成年患者，他们接受了经尿道肿瘤切除术并接受了卡介苗或表柔比星滴注治疗。 SF-36 身体和心理健康方面的调查问卷用于 QoL 评估。同样，STAI-Y 被引入用于状态（STAI-Y1）和特质焦虑（STAI-Y2）评估。

 结果：

筛选了117名符合条件的患者，最终108名进入研究； 9例患者因疾病复发而被排除。 17 名患者 (15.7%) 接受表阿霉素（Ta-T1，低级别肿瘤）治疗，而 91 名患者 (84.3%) 接受卡介苗治疗（T1，高级别肿瘤）。对于 SF-36 物理，先是下降 6 个月，然后在 12 个月时有所改善 ( p = 0.008)。同样，SF-36 心理健康评分有所增加 ( p = 0.03)。与 STAI-Y2 分数 ( p = 0.945) 相比，状态焦虑的长期减少被确定 ( p = 0.001)。术前 SF-36 身体状况与年龄呈负相关 ( p = 0.029)，而不饮酒则与较低的心理健康状况相关 ( p = 0.003)。总体而言，患者特征、习惯和所接受的治疗并不影响术后的生活质量和焦虑。

 结论：

随访期间患者的生活质量和焦虑有所改善。尽管如此，仍需要进一步更大规模的研究来支持我们的发现。