Health-related quality of life in long-term survivors after renal cancer treatment

Objective. The most important outcome of renal cell carcinoma (RCC) treatment is survival. However, all cancer treatment should evaluate the health-related quality of life (HRQoL) outcome of the treatment. This has not been sufficiently documented in RCC. The aim of this investigation was therefore to document the HRQoL outcome of RCC. Material and methods. All 413 RCC patients treated with radical or partial nephrectomy at Haukeland University Hospital, Norway, during the period 1997-2010 were included. After exclusions, invitations to participate were mailed to 260 patients; 185 patients (71%) returned the questionnaires. In addition, a cohort of general head and neck squamous cell carcinoma (HNSCC) patients, a cohort of laryngectomized HNSCC patients, and a cohort from the general population of Norway, were used to compare the RCC patients' HRQoL scores. Results. Performance status as measured by the American Society of Anesthesiologists (ASA) score and Eastern Cooperative Oncology Group (ECOG) classification at diagnosis showed an inverse relation to HRQoL [maximum coefficient of variation (CVmax) = 5.3%, p < 0.05]. Flank and open transabdominal approaches to RCC tumour resection were followed by reduced HRQoL compared with a general cohort of Norwegian citizens. However, the laparoscopically treated RCC patients had HRQoL scores at the level of the population. The indices general health/QoL, the functional indices, and the symptom indices fatigue, pain, sleep, nausea and vomiting, constipation and diarrhoea were particularly affected. Conclusion. The results show that RCC patients, and in particular those treated by a flank approach but not those treated by minimal invasive surgery, have a multifacetedly reduced HRQoL compared to a general population cohort.