Assessing utilities for muscle-invasive bladder cancer-related health states.
Urol Oncol
; 41(11): 456.e7-456.e12, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37524576
ABSTRACT
OBJECTIVES:
How patients value functional outcomes against oncologic outcomes during decision-making for muscular-invasive bladder cancer (MIBC) remains unclear. We sought to quantify individuals' preferences on a scale of 0 to 1, where 1 represents perfect health and 0 represents death.METHODS:
Descriptions of 6 hypothetical health states were developed. These included Neoadjuvant chemotherapy followed by radical cystectomy with ileal conduit (IC) or with neobladder reconstruction (NB), Transurethral resection and chemotherapy/radiation (CRT), CRT requiring salvage cystectomy (SC), Recurrent/metastatic bladder cancer after local therapy (RMBC), and Metastatic bladder cancer (MBC). Descriptions consisted of diagnosis, treatments, adverse effects, follow-up protocol, and prognosis and were reviewed for accuracy by expert panel. Included individuals were asked to evaluate states using the visual analog scale (VAS) and standard gamble (SG) methods.RESULTS:
Fifty-four individuals were included for analysis. No score differences were observed between IC, NB, and CRT on VAS or SG. On VAS, SC (valueâ¯=â¯0.429) was rated as significantly worse (P < 0.001) than NB (valueâ¯=â¯0.582) and CRT (valueâ¯=â¯0.565). However, this was not the case using the SG method. Both RMBC (VAS valueâ¯=â¯0.178, SG valueâ¯=â¯0.631) and MBC (VAS valueâ¯=â¯0.169, SG valueâ¯=â¯0.327) rated as significantly worse (P < 0.001) than the other states using both VAS and SG.CONCLUSIONS:
Within this sample of the general population, preferences for local treatments including IC, NB, and CRT were not found to be significantly different. These values can be used to calculate quality-adjusted life expectancy in future cost-effectiveness analyses.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Bexiga Urinária
/
Recidiva Local de Neoplasia
Tipo de estudo:
Guideline
/
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article