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Patient-reported health-related quality of life outcomes following cytoreductive nephrectomy
Andrew G. Percy, MA1, Joshua R. Kaplan, M.D.1, Susanna J. Jacobus, M.S.2, Sarah B. Kim, B.A.1, Andrew A. Wagner, M.D.1.
1Beth Israel Deaconess Medical Center, Boston, MA, USA, 2Dana-Farber Cancer Institute, Boston, MA, USA.

BACKGROUND: Few studies have investigated the impact of cytoreductive nephrectomy (CN) on short-term health-related quality of life (HRQOL). We prospectively evaluated the clinical and HRQOL outcomes in patients undergoing CN at a single institution. METHODS: HRQOL was measured using the Convalescence and Recovery Evaluation(CARE) and the Short Form-12(SF-12), administered preoperatively and at 2, 4, and 12 weeks. Perioperative clinical data and HRQOL changes over time were evaluated. Linear mixed models were used to evaluate longitudinal HRQOL scores, with missingness assumed random. Possible covariance structures were evaluated based on fit statistics. A two-sided 0.05 p-value was considered significant. RESULTS: Forty-six patients underwent CN since November 2006. Since August 2009, 18 patients were enrolled in a prospective IRB-approved study evaluating HRQOL. Demographics, clinical results, and complications were similar between the HRQOL subgroup of 18 patients and larger cohort of 46. The CARE pain, gastrointestinal (GI) and activity domain scores and the SF-12 physical component summary (PCS) were sensitive to changes in HRQOL (p<0.001), whereas the cognitive domain scores from both instruments did not change from pre-surgical baseline to post-surgical follow-up (Fig. 1). The CARE composite score demonstrated that 71% and 77% of patients returned to within 90% of baseline 4 and 12 weeks after CN, respectively. CONCLUSIONS: Most CN patients returned to near-baseline overall HRQOL by 4 weeks.


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