Changes in health-related quality of life outcomes in older patients with kidney cancer: A longitudinal cohort analysis with matched controls

Naleen Raj Bhandari, Songthip T. Ounpraseuth, Mohamed H. Kamel, Erin E. Kent, Carrie McAdam-Marx, J. Mick Tilford, Nalin Payakachat

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Current evidence regarding health-related quality of life (HRQoL) changes among patients with kidney cancer (KC) is limited. We characterized HRQoL changes from before (baseline) to after (follow-up) diagnosis of KC in older Americans relative to matched controls, and identified sociodemographic and clinical factors associated with HRQoL changes in older patients with KC. Materials and Methods: This longitudinal, population-based, retrospective cohort study used data from Surveillance, Epidemiology and End Results linked with Medicare Health Outcomes Survey, 1998–2013. Participants aged ≥65 years with baseline and follow-up survey data were identified. Those with primary KC (n = 186) were matched to adults without cancer (n = 558). HRQoL (physical component summary and mental component summary [MCS]) changes in KC patients were compared using generalized linear mixed-effects models to those of controls. Regression models were used to identify baseline factors associated with HRQoL changes. Results: The adjusted least squares mean (95% confidence interval) reduction in physical component summary from baseline to follow-up was greater in KC patients vs. controls (−4.1 [−5.6, −2.7] vs. −2.3 [−3.1, −1.4], P = 0.025). While the reduction in MCS was similar in both groups (−2.4 [−3.9, −0.8] vs. −1.5 [−2.4, −0.6], P = 0.338). Lower income and distant stage KC predicted greater declines in MCS among KC patients. Conclusion: KC significantly affects overall general health in older patients, with sociodemographic factors and distant KC predicting greater reductions in HRQoL. Findings may help clinicians set patient expectations about their HRQoL post-diagnosis and increase clinician awareness of risk factors for HRQoL deterioration.

Original languageEnglish (US)
Pages (from-to)852.e11-852.e20
JournalUrologic Oncology: Seminars and Original Investigations
Volume38
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Health-related quality of life
  • Kidney cancer
  • Longitudinal
  • Noncancer
  • SEER-MHOS

ASJC Scopus subject areas

  • Oncology
  • Urology

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