Impact of late effects after treatment for bladder cancer with radical cystectomy on Quality of life - a case-control study

Sep 23, 2026

Uploaded by Patrick

Radical cystectomy (RC) is the gold standard for muscle-invasive bladder cancer (MIBC), yet evidence on late effects and their consequences for patients’ quality of life (QoL) remains limited. This cross-sectional case-control study combines Danish register data with a questionnaire to describe incidence of late effects and assess QoL. MIBC patients diagnosed 2015–2020 were compared with 6 matched controls per patient, using EORTC-QLQ-C30 and MIBC-specific EORTC-QLQ-BLM30. Results show similar functional QoL and overall QoL between groups, while registry data indicate higher infection and hydronephrosis risk among cases and fatigue correlates strongly with impaired QoL.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Late effects and QoL assessment

Methods

Patient selection

Results

Interpretation

ORIGINAL ARTICLE Impact of late effects after treatment for bladder cancer with radical cystectomy on Quality of life: a case-control study Rikke V. Millinga,b, Ninna K. Nielsena,b, Charlotte Graugaard-Jensena,b, Peter Christensenb,c, Helle Pappotd and Jørgen B. Jensena,b a Department of Urology, Aarhus University Hospital, Aarhus, Denmark; bDepartment of Clinical Medicine, Aarhus University, Aarhus, Denmark; c Department of Surgery,Aarhus University Hospital, Aarhus, Denmark; dDepartment of Oncology, Rigshospitalet, Copenhagen, Denmark ABSTRACT Background and purpose: The gold standard when treating muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC), a procedure that holds the potential to affect the function of several pelvic organs, causing an impact on the patient’s Quality of Life (QoL) . Knowledge of the late effects following bladder cancer and treatment with RC is sparse. The aim is to describe the incidence of late effects and to investigate the impact on QoL. Methods: A cross-sectional study using register data in combination with a questionnaire, measuring pelvic organ specific symptoms to treatment and QoL. MIBC patients diagnosed between 2015 and 2020 and able to receive digital mail was invited. For each MIBC patient, 6 age-and gender matched controls were invited. QoL was measured using EORTC-QLQ-C30. The MIBC specific EORTC-QLQ-BLM30 was administered to cases only. Results: A total of 628 (54.3%) MIBC patients and their 1,204 (37.3%) matched controls responded. Median age was 73. Mean time since RC was 4.9 (SD 2.1) years. Scoring of the functional items on EORTC-QLQ-C30 and overall QoL were similar for cases and controls. Regarding late effects, similar responses were seen on questionnaire data when comparing cases and controls. On registry data, a higher risk of infections and hydronephrosis were seen for cases. A strong correlation between fatigue and impaired QoL was identified. Interpretation: MIBC patients were more often diagnosed with late effects such as infections and hydronephrosis, compared to controls. In spite of this, MIBC patients overall QoL was equal to that of the controls. ARTICLE HISTORY Received 30 July 2024 Accepted 30 November 2024 Published 8 January 2025 KEYWORDS Bladder cancer; late effects; quality of life; radical cystectomy Introduction Bladder cancer is the 10th most common cancer, affecting males and females in a 4:1 ratio. Bladder cancer can be either non-muscle invasive (NMIBC) or muscle invasive (MIBC). The gold standard when treating high risk NMIBC and MIBCis radical cystectomy (RC) with urinary diversion [1] . In addition to the bladder being removed and a conduit being created from the bowel, RC includes removal of the prostate and the seminal vesicles for men, and for most women, the removal of the anterior vaginal wall, the uterus, and ovaries [2, 3]. Thus, the surgery has the potential to affect or disrupt the function of several pelvic organs, causing a severe impact on the patient’s life, which to some extend can be measured by surveying quality of life (QoL) [4] . Various questionnaires have been developed to measure QoL. In bladder cancer research, the most frequently used generic questionnaires are the European Organisation for Research and Treatment of Cancer’s (EORTC) EORTC-QLQ-C30 [5] and the Functional Assessment of Cancer Therapy’s (FACT) FACT-G [6]. These generic questionnaires can be combined with bladder cancer specific questionnaires, most frequently used is the EORTC-QLQ-BLM30 [7] and the FACT-Bl [8] . Furthermore, symptom-specific questionnaires measuring for example sexual health has been developed and the EORTC-SHQ-C22 is used to measure sexual health among cancer patients [9] . Using these instruments, several studies have demonstrated the impact of bladder cancer and its treatment on QoL, which often leads to more deterioration in QoL compared to other pelvic organ cancers [10–12] . One explanation f

FAQs

What is the study’s main objective regarding bladder cancer survivors?

To describe the incidence of late effects after radical cystectomy (RC) and investigate how these late effects impact patients’ quality of life (QoL).

How were QoL and late effects measured in this study?

QoL was measured using EORTC-QLQ-C30 for all participants, and the MIBC-specific EORTC-QLQ-BLM30 was administered to cases only; late effects were evaluated using questionnaire data and registry data.

What were the key findings on QoL and late effects when comparing cases and matched controls?

Functional scores and overall QoL were similar between MIBC patients and controls, but registry data showed a higher risk of infections and hydronephrosis in cases. A strong correlation was found between fatigue and impaired QoL.

Sep 23, 2026

Uploaded by Patrick