Factors predicting health-related quality of life recovery in patients undergoing surgical treatment for renal tumors: prospective evaluation using the RAND SF-36 Health Survey.

Background: Most newly diagnosed kidney cancers present at localized stages.With appropriatetreatments, the cancer-specific survival rates of such patients are extremely high,which makes patients’ health-related quality of life (HRQoL) a relevant issue. To date, most ofthe available studies on HRQoL have been biased by the absence of baseline HRQoLassessments and by retrospective designs.Objective: To evaluate the baselineHRQoL of patients with kidney cancer, comparative HRQoLduring the first year after surgery, and the prognostic factors predictive of HRQoL recovery.Design, setting, and participants: We prospectively collected the data of all patients undergoingsurgery for kidney tumors at a tertiary academic referral center from February 2006 toSeptember 2007.Interventions: Patients underwent nephron-sparing surgery (NSS) or radical nephrectomy(RN).Measurements: Patients were invited to self-complete the validated, Italian version of theRAND 36-Item Health Survey 1.0 (SF-36) before surgery, 6 mo after surgery, and 12 mo aftersurgery.Results and limitations: Overall, 129 consecutive patients were evaluated. No significantdifferences were found between the baseline scores of our patients and age- and sexmatchednormative data for the Italian general population. Comparing the baseline SF-36scores to those at 6 mo and 12 mo, there was statistically significant worsening in thephysical domains and improvement in the emotional domains (all p < 0.05). About 50–80% ofpatients returned to baseline scores 6 mo and 12 mo after surgery. Age, body mass index(BMI), educational level, occupational status, New York Heart Association (NYHA) functionalclass, tumor mode of presentation, pathologic stage, size, and histologic subtype wereassociated with 6-mo and 12-mo return to the baseline HRQoL scores. The main limitationof the study was the lack of a disease-specific questionnaire.Conclusions: Most patients returned to preoperative HRQoL within 12 mo after RN or NSS.Several patient features, clinical variables, and pathologic tumor variables predict the returnof HRQoL.