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Pd11-01 Impact of Post-treatment Psychiatric Illness on Survival Outcomes Following Treatment for Patients With Muscle-invasive Bladder Cancer

Year: 2018

Type: article

Abstract: You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2018PD11-01 IMPACT OF POST-TREATMENT PSYCHIATRIC ILLNESS ON SURVIVAL OUTCOMES FOLLOWING TREATMENT FOR PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER Christopher Kosarek, Usama Jazzar, Yong Shan, Zachary Klaassen, Jinhai Huo, Edgar Esparza, Hemalkumar Mehta, Yong-Fang Kuo, Simon Kim, Douglas Tyler, Stephen Freedland, Ashish Kamat, Dwight Wolf, and Stephen Williams Christopher KosarekChristopher Kosarek More articles by this author , Usama JazzarUsama Jazzar More articles by this author , Yong ShanYong Shan More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , Jinhai HuoJinhai Huo More articles by this author , Edgar EsparzaEdgar Esparza More articles by this author , Hemalkumar MehtaHemalkumar Mehta More articles by this author , Yong-Fang KuoYong-Fang Kuo More articles by this author , Simon KimSimon Kim More articles by this author , Douglas TylerDouglas Tyler More articles by this author , Stephen FreedlandStephen Freedland More articles by this author , Ashish KamatAshish Kamat More articles by this author , Dwight WolfDwight Wolf More articles by this author , and Stephen WilliamsStephen Williams More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.624AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatments for muscle-invasive bladder cancer are multimodal, complex and often carry significant physical and psychological morbidity risks. We sought to define the incidence and types of psychiatric illnesses diagnosed following treatment and determine the impact on survival outcomes. METHODS A total of 3,709 patients diagnosed with clinical stage T2-T4a bladder cancer from January 1, 2001 to December 31, 2011 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare were analyzed. We determined the incidence of psychiatric diagnosis for each treatment and used multivariable analysis to determine predictors associated with psychiatric diagnoses. Cox proportional hazards models were used to determine the impact of post-treatment psychiatric diagnosis on survival outcomes. RESULTS Of the 3,709 patients, 1,870 (50.4%) were diagnosed with post-treatment psychiatric disorders with the most common diagnoses being mental and behavioral disorder due to psychoactive substance use and depressive disorders, respectively. Patients who underwent radical cystectomy were found to be at a significantly greater risk of having a post-treatment psychiatric illness in comparison to patients who underwent radiotherapy and/or chemotherapy (Hazard Ratio, 1.19; 95% Confidence Interval = 1.08-1.32; P < 0.001). In adjusted analyses, patients with a post-treatment psychiatric diagnosis were found to have significantly worse overall and cancer-specific survival than patients without a post-treatment psychiatric diagnosis across all treatments. CONCLUSIONS Half of muscle-invasive bladder cancer patients who underwent treatment were diagnosed with a psychiatric disorder which resulted in worse survival outcomes as compared to patients without a post-treatment psychiatric diagnosis. In order to optimize the benefit of these treatments, addressing the non-oncologic needs of patients (i.e. depression screening, treatment, and survivorship clinics) are needed to improve survival outcomes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e233 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Christopher Kosarek More articles by this author Usama Jazzar More articles by this author Yong Shan More articles by this author Zachary Klaassen More articles by this author Jinhai Huo More articles by this author Edgar Esparza More articles by this author Hemalkumar Mehta More articles by this author Yong-Fang Kuo More articles by this author Simon Kim More articles by this author Douglas Tyler More articles by this author Stephen Freedland More articles by this author Ashish Kamat More articles by this author Dwight Wolf More articles by this author Stephen Williams More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Source: The Journal of Urology

DOI: 10.1016/j.juro.2018.02.624