Mp08-02 Development of De Novo Financial Toxicity in Bladder Cancer Patients Following Radical Cystectomy and Its Impact on Health-Related Quality of Life

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP08)1 May 2024MP08-02 DEVELOPMENT OF DE NOVO FINANCIAL TOXICITY IN BLADDER CANCER PATIENTS FOLLOWING RADICAL CYSTECTOMY AND ITS IMPACT ON HEALTH-RELATED QUALITY OF LIFE Thilo Westhofen, Gerald B. Schulz, Alexander Buchner, Lennert Eismann, Severin Rodler, Armin Becker, Christian G. Stief, and Alexander Kretschmer Thilo WesthofenThilo Westhofen , Gerald B. SchulzGerald B. Schulz , Alexander BuchnerAlexander Buchner , Lennert EismannLennert Eismann , Severin RodlerSeverin Rodler , Armin BeckerArmin Becker , Christian G. StiefChristian G. Stief , and Alexander KretschmerAlexander Kretschmer View All Author Informationhttps://doi.org/10.1097/01.JU.0001008780.87855.57.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Financial toxicity (FT) is a patient reported outcome measure (PROM), defined as the detrimental effect of financial burden caused by a cancer diagnosis on patient's well-being. Although FT is common among cancer patients, little is known about FT following radical cystectomy for bladder cancer in countries with universal health coverage. We aimed to assess de novo FT and its impact on health-related quality of life (HRQOL) by providing PROM data from a large contemporary cohort of patients undergoing RC with a systematic follow-up of up to 10 yrs. METHODS: 1514 consecutive patients who underwent RC at a large tertiary care center were included. PROMs were prospectively assessed preoperatively, at 3 mo, then annually until a maximum follow-up of 120 mo, applying the validated EORTC QLQ-C30-, the bladder cancer-specific QLQ-BLM30- and FACT-BL-questionnaires. Patients reporting FT prior RC were excluded. FT was assessed by the "financial toxicity subscale" (FTS) of the EORTC QLQ-C30, meaningful FT was defined as FTS ≥17. Multivariable regression analysis was used to identify predictors for the development of de novo FT. Separate modeling of longitudinal HRQOL was performed for patients with de novo FT (FT-cohort) and without FT (no-FT-cohort). RESULTS: 37.6% of the included patients reported de novo FT within 12 months after RC with a mean FTS-score of 55.2 (26.3). Baseline characteristics did not differ between the FT-cohort and the no-FT-cohort (p-range .072-.370). Multivariable logistic regression analysis revealed gender, residential factors, smoking history and type of urinary diversion to independently predict de novo FT following RC (p-range .017-.049). At baseline, no significant difference in general HRQOL assessed by the global health status domain (GHS) was found between both cohorts (p=.934). Postoperatively, patients with de novo FT, reported significantly worse, general HRQOL compared to patients without FT (p=.0.001). Similarly, in the longitudinal analysis, the FT-cohort reported a significantly worse GHS-Score up to 84 mo after RC. Between 96 mo and 120 mo, GHS-Scores evened out (.317 – .992). CONCLUSIONS: The current study provides prospective data from a unique contemporary patient cohort, which reveals independent predictors for de novo FT following RC. Furthermore, it displays the natural course of general HRQOL for patients who develop de novo FT. Those support guidance of treatment decision-making for patients with BC. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e114 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Thilo Westhofen More articles by this author Gerald B. Schulz More articles by this author Alexander Buchner More articles by this author Lennert Eismann More articles by this author Severin Rodler More articles by this author Armin Becker More articles by this author Christian G. Stief More articles by this author Alexander Kretschmer More articles by this author Expand All Advertisement PDF downloadLoading ...