BACKGROUND: To compare demographics, pathologic features, performance scores, comorbidities, symptoms and responses to quality of life (QoL) surveys between nephron-sparing surgery (NSS) and radical nephrectomy (RN) patients prior to surgical intervention.
Previous investigators have compared QoL outcomes for patients undergoing RN and NSS; however, there are limited data comparing QoL-related characteristics at baseline between these groups.
METHODS: We identified 144 patients with localized RCC who underwent either NSS (n = 71) or RN (n = 73) between May '07-November '12. We abstracted baseline data on demographic and clinic-pathologic variables as well as responses to the SF-36 and FACT-G surveys from our prospective registry. We amended the FACT-G with 8 additional questions designed to address RCC-specific QoL. For comparisons between the two groups, we employed Wilcoxon rank-sum and Fisher's Exact tests where appropriate.
RESULTS: We observed RN patients to have more aggressive pathology. We noted no difference in performance scores between the two groups; however, RN patients were more likely to have higher Charlson scores (p = 0.022) and various symptoms at presentation (all p < 0.001). For the QoL surveys, we did not observe differences on the FACT-G; however, we noted evidence of differential scores between the two groups on specific domains of the SF-36 (e.g. Mental Health; p 0.022) and the RCC-specific QoL questions added to the FACT-G.
CONCLUSIONS: We report baseline differences between RN and NSS patients on clinico-pathologic as well as QoL-related metrics. As issues of survivorship become increasingly important, our results underscore the need to consider baseline status in evaluations of QoL-related outcomes for patients undergoing surgery for RCC.
Written by:
Arnold ML, Thiel DD, Diehl N, Wu KJ, Ames S, Parker AS. Are you the author?
Department of Health Sciences Research, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Reference: BMC Urol. 2013 Oct 22;13(1):52.
doi: 10.1186/1471-2490-13-52
PubMed Abstract
PMID: 24148752
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