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Quality of life outcomes in patients with localised renal cancer: a literature review.

Published version
Peer-reviewed

Type

Article

Change log

Abstract

PURPOSE: Patients with localised renal cell carcinoma (RCC) can expect excellent oncologic outcomes. As such, there has been a shift towards maximising health-related quality of life (HRQoL). A greater understanding of HRQoL outcomes associated with different treatment options for RCC can facilitate patient-centred care, shared decision-making and enable cost utility analyses to guide health policies. The aim of this literature review was to evaluate the evidence regarding HRQoL following different management strategies for localised RCC. METHODS: Three databases were searched to identify studies reporting HRQoL in patients with localised renal cancer, including Medline, the Tuft's Medical Centre Cost Effectiveness Analysis registry and the EuroQol website. RESULTS: Considerable methodological heterogeneity was noted. Laparoscopic nephrectomy was associated with significantly better short-term physical function compared to open surgery, although the effect on mental function was inconclusive. Nephron-sparing surgery was associated with better physical function compared to radical surgery. Patients' perception of remaining renal function was a significant independent predictor of HRQoL, rather than surgery type. Tumour size, stage, post-operative complications, age, body mass index, occupational status, educational level and comorbidities were significant predictors of HRQoL. Only three studies were available regarding non-surgical management options and very little data were available regarding the impact of follow-up protocols and long-term effects of "cancer survivorship." CONCLUSION: There is a need for validated and reproducible RCC-specific HRQoL instruments and standardisation amongst studies to enable comparisons. Increased awareness regarding determinants of poor HRQoL may enable high-risk patients to receive tailored support.

Description

Keywords

Localised renal cell carcinoma, Nephrectomy, Quality of life, Review, Utility, Age Factors, Body Mass Index, Carcinoma, Renal Cell, Comorbidity, Cost-Benefit Analysis, Decision Making, Educational Status, Employment, Health Policy, Health Status, Humans, Kidney Neoplasms, Neoplasm Staging, Nephrectomy, Nephrons, Organ Sparing Treatments, Patient Reported Outcome Measures, Patient-Centered Care, Postoperative Complications, Quality of Life, Tumor Burden

Journal Title

World J Urol

Conference Name

Journal ISSN

0724-4983
1433-8726

Volume Title

36

Publisher

Springer Science and Business Media LLC
Sponsorship
Urology Foundation (unknown)
The urology foundation