Patient-reported outcomes in non-muscle invasive bladder cancer: a mixed-methods systematic review
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Patient‑reported outcomes in non‑muscle invasive bladder cancer: a mixed‑methods systematic review Claudia Rutherford1 · Manish I. Patel2,3 · Margaret‑Ann Tait1 · David P. Smith4,5,6,7 · Daniel S. J. Costa1,8,9 · Shomik Sengupta10,11,12 · Madeleine T. King1 Accepted: 9 September 2020 © Springer Nature Switzerland AG 2020
Abstract Objective Non-muscle invasive bladder cancer (NMIBC) is a chronic condition requiring repeated treatment and endoscopic examinations that can occur life-long. In this context, patient-reported outcomes (PROs) are important considerations to patients and managing clinicians. We undertook a systematic review to synthesise PRO results relevant to NMIBC treatment to explore trajectories overtime and differences between treatment options. Methods We searched databases AMED, MEDLINE, EMbase, PsycINFO, Web of Knowledge and Scopus (inception to 5th December 2019), reference lists and contacted key authors to identify studies that reported PROs after NMIBC treatment. Two reviewers independently applied inclusion and quality criteria and extracted findings. Results for PROs were synthesised for treatment groups across three time periods: acute/during induction therapy; during maintenance therapy; and long-term follow-up (> 1 year). Results Of 3193 papers screened, 29 were eligible. These provided evidence about induction treatment effects, but few reported maintenance or long-term evidence, and evidence about differences between NMIBC treatment options was lacking. A range of symptoms (pain in bladder area, urinary frequency and urgency, pain or burning during urination) were commonly experienced during and soon after treatment for NMIBC. Less common symptoms included fatigue, disrupted sleep and gastrointestinal problems. Conclusions Treatments for NMIBC can cause symptoms and functional impairment during the acute treatment phase and reduce quality of life. Clinicians should be aware of these impairments to prepare patients for short-term sequelae and enable those with treatment options to exercise preferences in choosing among them. However, gaps in current evidence limit our understanding of PRO trajectories from diagnosis through to long-term survivorship and treatment effects. Keywords Non-muscle invasive bladder cancer · Early bladder cancer · Quality of life · Patient-reported outcomes · Systematic review
Background Bladder cancer (BC) is common worldwide [1], with most cases (70–80%) diagnosed as non-muscle invasive bladder cancer (NMIBC) [2]. For NMIBC, with treatment, five-year survival is > 80% [3]. Treatment for NMIBC involves endoscopic resection of bladder tumours, sometimes followed by Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02637-9) contains supplementary material, which is available to authorized users. * Claudia Rutherford [email protected] Extended author information available on the last page of the article
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