Utility of Patient-Reported Symptom and Functional Outcomes to Indicate Recovery after First 90 Days of Radical Cystectomy: A Longitudinal Study

作者全名："Wang, Xin Shelley; Bree, Kelly K.; Navai, Neema; Kamal, Mona; Shen, Shu-En; Letona, Elizabeth; Cleeland, Charles S.; Shi, Qiuling; Gottumukkala, Vijaya"

作者地址："[Wang, Xin Shelley; Kamal, Mona; Shen, Shu-En; Letona, Elizabeth; Cleeland, Charles S.] Univ Texas MD Anderson Canc Ctr, Dept Symptom Res, Houston, TX 77030 USA; [Bree, Kelly K.; Navai, Neema] Univ Texas MD Anderson Canc Ctr, Dept Urol, Houston, TX 77030 USA; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth & Management, Chongqing 400016, Peoples R China; [Gottumukkala, Vijaya] Univ Texas MD Anderson Canc Ctr, Dept Anesthesiol & Perioperat Med, Houston, TX 77030 USA"

通信作者："Wang, XS (通讯作者)，Univ Texas MD Anderson Canc Ctr, Dept Symptom Res, Houston, TX 77030 USA."

来源：CANCERS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001005537900001

JCR分区：Q1

影响因子：4.5

年份：2023

卷号：15

期号：11

开始页：　

结束页：　

文献类型：Article

关键词：postoperative symptoms; functional recovery; patient-reported outcomes (PROs); perioperative care; MD Anderson Symptom Inventory (MDASI); cystectomy

摘要："One barrier to implementing patient-reported outcomes (PROs) during perioperative care for bladder cancer (BLC) patients is the lack of empirical reports of meaningful symptom burden that are associated with postoperative recovery. This study aimed to describe symptom burden and functioning status for 3 months post-radical cystectomy, using a validated disease-specific PRO measure tool, the MD Anderson Symptom Inventory (the MDASI-PeriOp-BLC). We found that the most severe symptom burden at baseline and discharge is associated with poor functional recovery post-radical cystectomy for BLC. These PROs could be used to identify BLC patients at the highest risk for poor functional recovery during the perioperative period. We also found that postoperative functional recovery assessment via PROs is more feasible than an objective performance measure. The completion of MDASI-PeriOp-BLC at preoperative, discharge and end of study was 100%, 79% and 77%, while Timed Up and Go test completion rates were 88%, 54% and 13%, respectively. Abstract: This is a longitudinal prospective study that tracked multiple symptom burden and functioning status for bladder cancer (BLC) patients for 3 months post-radical cystectomy at The University of Texas MD Anderson Cancer Center, using a validated disease-specific patient-reported outcome measure (PROM) tool, the MD Anderson Symptom Inventory (the MDASI-PeriOp-BLC). The feasibility of collecting an objective measure for physical functioning, using ""Timed Up & Go test"" (TUGT) and PRO scores at baseline, discharge and end of study, was tested. Patients (n = 52) received care under an ERAS pathway. The more severe scores of fatigue, sleep disturbance, distress, drowsiness, frequent urination and urinary urgency at baseline predicted poor functional recovery postoperatively (OR = 1.661, 1.039-2.655, p = 0.034); other more severe symptoms at discharge (pain, fatigue, sleep disturbance, lack of appetite, drowsiness, bloating/abdominal tightness) predicted poor functional recovery (OR = 1.697, 1.114-2.584, p = 0.014) postoperatively. Compliance rates at preoperative, discharge and end of study were 100%, 79% and 77%, while TUGT completion rates were 88%, 54% and 13%, respectively. This prospective study found that more severe symptom burden at baseline and discharge is associated with poor functional recovery post-radical cystectomy for BLC. The collection of PROs is more feasible than using performance measures (TUGT) of function following radical cystectomy."

基金机构：National Institutes of Health/National Cancer Institute [R01CA205146]

基金资助正文："This study was supported by a grant from the National Institutes of Health/National Cancer Institute, R01CA205146, to XS Wang."