Propensity-matched analysis of patient-reported outcomes for neoadjuvant chemotherapy prior to radical cystectomy

Michael A. Feuerstein, Leah Goldstein, Brieyona Reaves, Arony Sun, Michael Goltzman, Bradley A. Morganstern, Ahmad Shabsigh, Dean F. Bajorin, Jonathan E. Rosenberg, S. Machele Donat, Harry W. Herr, Vincent P. Laudone, Thomas M. Atkinson, Yuelin Li, Guido Dalbagni, Bruce D. Rapkin, Bernard H. Bochner

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate patient-reported outcomes (PROs) for bladder cancer patients undergoing neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) using longitudinal data and propensity-matched scoring analyses. Methods: 155 patients with muscle-invasive bladder cancer scheduled for RC completed the European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30, EORTC QLQ-BLM30, Fear of Recurrence Scale, Mental Health Inventory and Satisfaction with Life Scale within 4 weeks of surgery. A propensity-matched analysis was performed comparing pre-surgery PROs among 101 patients who completed NAC versus 54 patients who did not receive NAC. We also compared PROs pre- and post-chemotherapy for 16 patients who had data available for both time points. Results: In propensity-matched analysis, NAC-treated patients reported better emotional and sexual function, mental health, urinary function and fewer financial concerns compared to those that did not receive NAC. Longitudinal analysis showed increases in fatigue, nausea and appetite loss following chemotherapy. Conclusion: Propensity-matched analysis did not demonstrate a negative effect of NAC on PRO. Several positive associations of NAC were found in the propensity-matched analysis, possibly due to other confounding differences between the two groups or actual clinical benefit. Longitudinal analysis of a small number of patients found small to modest detrimental effects from NAC similar to toxicities previously reported. Our preliminary findings, along with known survival and toxicity data, should be considered in decision-making for NAC.

Original languageEnglish (US)
JournalWorld Journal of Urology
DOIs
StatePublished - Jan 1 2019

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Cystectomy
Drug Therapy
Urinary Bladder Neoplasms
Patient Reported Outcome Measures
Mental Health
Appetite
Nausea
Fear
Fatigue
Decision Making
Organizations

Keywords

  • Bladder cancer
  • Health-related quality of life
  • Patient-centered research
  • Patient-reported outcomes

ASJC Scopus subject areas

  • Urology

Cite this

Feuerstein, M. A., Goldstein, L., Reaves, B., Sun, A., Goltzman, M., Morganstern, B. A., ... Bochner, B. H. (2019). Propensity-matched analysis of patient-reported outcomes for neoadjuvant chemotherapy prior to radical cystectomy. World Journal of Urology. https://doi.org/10.1007/s00345-019-02692-z

Propensity-matched analysis of patient-reported outcomes for neoadjuvant chemotherapy prior to radical cystectomy. / Feuerstein, Michael A.; Goldstein, Leah; Reaves, Brieyona; Sun, Arony; Goltzman, Michael; Morganstern, Bradley A.; Shabsigh, Ahmad; Bajorin, Dean F.; Rosenberg, Jonathan E.; Donat, S. Machele; Herr, Harry W.; Laudone, Vincent P.; Atkinson, Thomas M.; Li, Yuelin; Dalbagni, Guido; Rapkin, Bruce D.; Bochner, Bernard H.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Feuerstein, MA, Goldstein, L, Reaves, B, Sun, A, Goltzman, M, Morganstern, BA, Shabsigh, A, Bajorin, DF, Rosenberg, JE, Donat, SM, Herr, HW, Laudone, VP, Atkinson, TM, Li, Y, Dalbagni, G, Rapkin, BD & Bochner, BH 2019, 'Propensity-matched analysis of patient-reported outcomes for neoadjuvant chemotherapy prior to radical cystectomy', World Journal of Urology. https://doi.org/10.1007/s00345-019-02692-z
Feuerstein, Michael A. ; Goldstein, Leah ; Reaves, Brieyona ; Sun, Arony ; Goltzman, Michael ; Morganstern, Bradley A. ; Shabsigh, Ahmad ; Bajorin, Dean F. ; Rosenberg, Jonathan E. ; Donat, S. Machele ; Herr, Harry W. ; Laudone, Vincent P. ; Atkinson, Thomas M. ; Li, Yuelin ; Dalbagni, Guido ; Rapkin, Bruce D. ; Bochner, Bernard H. / Propensity-matched analysis of patient-reported outcomes for neoadjuvant chemotherapy prior to radical cystectomy. In: World Journal of Urology. 2019.
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abstract = "Purpose: To evaluate patient-reported outcomes (PROs) for bladder cancer patients undergoing neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) using longitudinal data and propensity-matched scoring analyses. Methods: 155 patients with muscle-invasive bladder cancer scheduled for RC completed the European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30, EORTC QLQ-BLM30, Fear of Recurrence Scale, Mental Health Inventory and Satisfaction with Life Scale within 4 weeks of surgery. A propensity-matched analysis was performed comparing pre-surgery PROs among 101 patients who completed NAC versus 54 patients who did not receive NAC. We also compared PROs pre- and post-chemotherapy for 16 patients who had data available for both time points. Results: In propensity-matched analysis, NAC-treated patients reported better emotional and sexual function, mental health, urinary function and fewer financial concerns compared to those that did not receive NAC. Longitudinal analysis showed increases in fatigue, nausea and appetite loss following chemotherapy. Conclusion: Propensity-matched analysis did not demonstrate a negative effect of NAC on PRO. Several positive associations of NAC were found in the propensity-matched analysis, possibly due to other confounding differences between the two groups or actual clinical benefit. Longitudinal analysis of a small number of patients found small to modest detrimental effects from NAC similar to toxicities previously reported. Our preliminary findings, along with known survival and toxicity data, should be considered in decision-making for NAC.",
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AU - Feuerstein, Michael A.

AU - Goldstein, Leah

AU - Reaves, Brieyona

AU - Sun, Arony

AU - Goltzman, Michael

AU - Morganstern, Bradley A.

AU - Shabsigh, Ahmad

AU - Bajorin, Dean F.

AU - Rosenberg, Jonathan E.

AU - Donat, S. Machele

AU - Herr, Harry W.

AU - Laudone, Vincent P.

AU - Atkinson, Thomas M.

AU - Li, Yuelin

AU - Dalbagni, Guido

AU - Rapkin, Bruce D.

AU - Bochner, Bernard H.

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N2 - Purpose: To evaluate patient-reported outcomes (PROs) for bladder cancer patients undergoing neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) using longitudinal data and propensity-matched scoring analyses. Methods: 155 patients with muscle-invasive bladder cancer scheduled for RC completed the European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30, EORTC QLQ-BLM30, Fear of Recurrence Scale, Mental Health Inventory and Satisfaction with Life Scale within 4 weeks of surgery. A propensity-matched analysis was performed comparing pre-surgery PROs among 101 patients who completed NAC versus 54 patients who did not receive NAC. We also compared PROs pre- and post-chemotherapy for 16 patients who had data available for both time points. Results: In propensity-matched analysis, NAC-treated patients reported better emotional and sexual function, mental health, urinary function and fewer financial concerns compared to those that did not receive NAC. Longitudinal analysis showed increases in fatigue, nausea and appetite loss following chemotherapy. Conclusion: Propensity-matched analysis did not demonstrate a negative effect of NAC on PRO. Several positive associations of NAC were found in the propensity-matched analysis, possibly due to other confounding differences between the two groups or actual clinical benefit. Longitudinal analysis of a small number of patients found small to modest detrimental effects from NAC similar to toxicities previously reported. Our preliminary findings, along with known survival and toxicity data, should be considered in decision-making for NAC.

AB - Purpose: To evaluate patient-reported outcomes (PROs) for bladder cancer patients undergoing neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) using longitudinal data and propensity-matched scoring analyses. Methods: 155 patients with muscle-invasive bladder cancer scheduled for RC completed the European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30, EORTC QLQ-BLM30, Fear of Recurrence Scale, Mental Health Inventory and Satisfaction with Life Scale within 4 weeks of surgery. A propensity-matched analysis was performed comparing pre-surgery PROs among 101 patients who completed NAC versus 54 patients who did not receive NAC. We also compared PROs pre- and post-chemotherapy for 16 patients who had data available for both time points. Results: In propensity-matched analysis, NAC-treated patients reported better emotional and sexual function, mental health, urinary function and fewer financial concerns compared to those that did not receive NAC. Longitudinal analysis showed increases in fatigue, nausea and appetite loss following chemotherapy. Conclusion: Propensity-matched analysis did not demonstrate a negative effect of NAC on PRO. Several positive associations of NAC were found in the propensity-matched analysis, possibly due to other confounding differences between the two groups or actual clinical benefit. Longitudinal analysis of a small number of patients found small to modest detrimental effects from NAC similar to toxicities previously reported. Our preliminary findings, along with known survival and toxicity data, should be considered in decision-making for NAC.

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