The following is a summary of “Assessing utilities for muscle-invasive bladder cancer-related health states,” published in the November 2023 issue of Urology by Chaballout, et al.
It’s still not clear how people with muscular-invasive bladder cancer (MIBC) weigh functional outcomes against oncologic outcomes when making decisions. For a study, researchers sought to determine how people felt about their choices on a scale from 0 to 1, where 0 means death and 1 means perfect health. There were descriptions made of 6 made-up health states. These were neoadjuvant chemotherapy followed by radical cystectomy with an ileal conduit (IC) or with neobladder reconstruction (NB), transurethral resection and chemotherapy/radiation (CRT), CRT requiring salvage cystectomy (SC), recurrent or metastatic bladder cancer after local therapy (RMBC), and metastatic bladder cancer (MBC).
The descriptions included the diagnosis, medicines, side effects, follow-up plan, and outlook. An expert group checked the descriptions to make sure they were correct. Participants were asked to rate states using the standard gamble (SG) and visual analog scale (VAS) methods. Fifty-four people were chosen to be analyzed. There were no score changes between IC, NB, and CRT on either VAS or SG. The VAS showed that SC (value = 0.429) was significantly worse (P < 0.001) than NB (value = 0.582) and CRT (value = 0.565). With the SG method, though, this wasn’t the case.
They found that RMBC (VAS = 0.178, SG = 0.631) and MBC (VAS = 0.169, SG = 0.327) were both significantly worse (P < 0.001) than the other states when they used both VAS and SG. There were no big differences in their choices for local treatments like IC, NB, and CRT in this group of people from the general community. In future cost-benefit studies, these numbers can be used to figure out the quality-adjusted life span.
Source: sciencedirect.com/science/article/abs/pii/S1078143923002399