Health related quality of life in patients treated with radical cystectomy and urinary diversion for urothelial carcinoma of the bladder: development and validation of a new disease specific questionnaire

J Urol. 2003 Nov;170(5):1926-30. doi: 10.1097/01.ju.0000092830.03247.ef.


Purpose: The impact of treatment on the health related quality of life (HRQOL) of patients is being recognized with increasing importance, particularly in those with urological malignancies. However, a validated disease and treatment specific instrument to assess HRQOL following radical cystectomy (RC) and urinary diversion (UD) is currently lacking. We report the results of a new questionnaire designed specifically to measure HRQOL in these patients.

Materials and methods: A 45-item questionnaire consisting of the Functional Assessment of Cancer Therapy (FACT)-General and 17 additional items designed to measure disease and treatment specific health outcomes were combined to form the Vanderbilt Cystectomy Index (FACT-VCI). FACT-VCI and the generic RAND 36-Item Health Survey (SF-36) were administered to 50 patients from our institution RC data base who were more than 1 year from the time of surgery. Each patient was asked to complete the survey at 1 and 4 weeks. The results of the SF-36 and FACT-VCI were correlated along with the first and second administration of the FACT-VCI.

Results: Overall FACT-VCI was found to have adequate internal consistency (Cronbach's alpha >0.70). Furthermore, intraclass correlation for the first and second administration of the VCI was 0.79. In addition, there was good correlation between the validated SF-36 and FACT-VCI (r = 0.81). The result was initial validation of a questionnaire for the assessment of HRQOL in patients following RC and UD.

Conclusions: Instruments designed to measure accurately HRQOL following RC and UD are in early development. We have now constructed and validated a disease and treatment specific questionnaire that can objectively assess HRQOL following RC and UD. A prospective longitudinal study of FACT-VCI is currently ongoing.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Transitional Cell / psychology
  • Carcinoma, Transitional Cell / surgery*
  • Cystectomy / psychology*
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / psychology*
  • Psychometrics
  • Quality of Life / psychology*
  • Reproducibility of Results
  • Sickness Impact Profile
  • Treatment Outcome
  • Urinary Bladder Neoplasms / psychology
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Diversion / psychology*
  • Urinary Reservoirs, Continent