Testis Tümörü Tedavisinde Hayat

KalitesiDr. Cenk ACAR

Pamukkale Üniversitesi

Üroloji Anabilim Dalı

SAĞLIĞIN TANIMI

(WHO)

Sağlık sadece hastalığın bulunmaması değil, tam

bir fiziksel,mental ve sosyal iyilik halidir.

HRQoL

• Hastalar tarafından bildirilen en önemli sonuç, “Sağlıkla İlişkili Yaşam Kalitesi(HRQoL)”dir.

• Sadece genel iyilik hali değil,

▫ Somatik semptomlar

▫ Fonksiyonellik

▫ Duygusal iyilik

▫ Sosyallik

▫ Vücut İmajı

HRQoL Araştırmaları

• Temel Amaç:

▫ Tıbbi bakımı iyileştirmek

▫ Tıbbi açıdan karar vermeye yardımcı olmak

Üroloji’deki HRQoL araçları

www.proqolid.org

HRQoL Araçları

HRQoL

Kansere Özgü

Genel

• Birbirlerinden etkilenirler

• HRQoL verilerini yazarken aralarındaki etkileşimler önemlidir.

HRQoL

GENEL KANSERE ÖZGÜ

• RAND Medical OutcomesStudy-36 item Health Survey(SF-36)

• Quality of Well-Being Scale(QWB)

• Sickness Impact Profile (SIP)

• Notthingam Health Profile

• European Organization for theResearch and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQC-30)

• Functional Assessment of Cancer Therapy (FACT)

• Cancer RehabilitationEvaluation System (CARES)

SF-36

• Altın Standart

• 8 farklı yaşam başlığını 36 soruda ele alır.

• 10 dakika civarında doldurma süresi

• Daha da kısaltılmış formu : SF-12

• Üroonkoloji Derneği tarafından hesaplama formülü mevcut.

EORTC QLQC-30

• 30 sorudan oluşmaktadır.

▫ 6 fonksiyonel skala

▫ 3 genel sağlık skalası

▫ 6 tek soru ( dispne, insomnia, iştah azalması, konstipasyon/diyare, maddi zorluk

• Üroonkoloji Derneği tarafından türkçe validasyonu yapılmıştır.

Literatür Taraması

• Testis Tm. Hayat Kalitesi

• 1989-2011 tarihleri arasında

▫ 32 orijinal makale

▫ 1 AUA meeting 2011 abstract

▫ 4 derleme

Author Year Patient Groups

HRQoL Instruments

PatientNumber

Follow-up(year) Journal

Spiegel et al. 2011 seminom, non-seminom

sf-36eortc qlqc30phq-9gad-7iief 193 NA AUA meeting

Wefel et al. 2011

NSGCT before Chemo, healthy population norms

neuropsyhcological testsanxiety (STAIS)depression (CES-D)

69 Cancer

Kim et al. 2011 Testis tm, non-testis tmSf-36

482 Qual Life Res

Osmanska et al. 2010 during Chemo, 6 mo. After Chemo

WHOQoL-BREFHospital Anxiety Depression Scale (HADS) 111 Psyciatr Pol

Vidrine et al. 2010

Baseline,post-Chemo or 3 mo. after diagnosis in surveillance group, 12 mo after diagnosis

Sf-36

116 Urology

Dahl et al. 2010Testis tm, age-matched population control

sf-36HADSRosenberg Self-esteemscale(RSES)BMI 1291(testis tm) 11 J cancer Surviv

Rossen et al. 2009 Surveillance, RT, Chemo

eortc qlqc30Depression ( Beck DepressionInventory-2)Fatigue (MultidimensionalFatigue Inventory-20)neurotoxic symptomsRaynaud-like phenomena 401 12,2 J Clin Oncol

Author Year Patient Groups

HRQoL InstrumentsPatientNumber

Follow-up(year) Journal

Skaali et al. 2009 testis tm

sf-36HADSRSESBrief Approach/Avoiding Coping Questionnaire (BACQ)Fatigue Questionnaire(FQ)Cancer Related stress:Impact of Event Scale (IES)Mini- International Neuropsychiatric Interview (MINI)Neuroticism: Eysenck Personality Questionnaire (EPQ-18)

1336 11,4 Psycho-Oncology

Orre et al. 2008Testis tm, general population

sf-36FQEPQ-18HADSIESBrief Sexual Function Inventory (BSFI) 1431 11

j PsychosomaticRes

Tuinman et al. 2007

before Chemo, after completion, 1 year after Chemo

SF-36IES

70Support CareCancer

Buijs et al. 2007Conventional Chemo, high dose Chemo

sf-36Visual analog scaleRotterdam Symptom Checklist 804 4,8 J Clin Oncol

Fleer et al. 2006 Testis tm

IESImpact of Traumatic Stressors Interview Schedule (ITSIS)

354 NAPatient ed andcounseling

Fleer et al. 2006 Testis tm

IESSF-36The Happiness index 354 NA Qual Life Res

Fleer et al. 2006 Testis tmSF-36

354 10Support CareCancer

Author Year Patient GroupsHRQoL Instruments Patient

NumberFollow-up

(year) Journal

Thorsenet al. 2005

Lymphomas-breast-testis tm.,healthy control

Astrand-Rhyming indirect bicycleergometer testeortc qlqc30HADS 111 J Clin Oncol

Huddart et al. 2005 Chemo,RT, Surveillance, control

eortc qlqc30fertility, gonadal and sexual functionLH,FSH,testosterone 640 4 Br J Cancer

Tuinman et al. 2005

during testis tm treatment, after treatment (survivor)

Maudsley Marital Questionnairemarital and sexual satisfaction 259 9,3

Support Care Cancer

Mykletun et al. 2005 Testis tm, general population

SF-36IES 1409 11 J Clin Oncol

Thorsen et al. 2005 Testis tm, general population

life style factor (Level of Physical Activity(LPA))HADS 1260 NA

Support Care Cancer

Miyake et al. 2004 Chemo±RPLND,RT,Surveillance

SF-36130 Oncol Rep

Tuinman et al. 2004

Testis tm patients and their spouses

SF-36IES 259 9,3 Eur J Cancer

Miyake et al. 2004

standart-dose Chemo, high doseChemo, surveillance

SF-36102 3 Int J Urol

Trask et al. 2003 prior, during, after Chemo

Brief Symptom Inventory-53 (BSI)Functional Assessment of Cancer Treatment-General (FACT-G) 16 NA

Psycho-Oncology

Thorsen et al. 2003

Chemo,RT, RPLND, general population

LPABMICo-morbidity 1276 12 Eur J Cancer

Author Year Patient GroupsHRQoL Instruments Patient

NumberFollow-up

(year) Journal

Fegg et al. 2003 before Chemo, after Chemo

Sociodemographic dataQuestionnaire for germcell tumour patient in surveillance-33 Questionnaire on partnership and sexual functioning-19 341 9,6 Br J Cancer

Rudberg et al. 2002 Testis tm, general population

Gothenburg Quality of life Instrument (GQL)Swedish HRQoL Questionnaire (SWEDQUAL)Symptom Checklist 392 11 Cancer Nursing

Caffo et al. 2001 RT for seminoma

Questionnaire of Quality of Life-44( non-validated) 98 10

Radiather and Oncol

Fossa et al. 1999

Bialteral orchiectomy patients under androgen replacement therapy

eortc qlqc30General Health Questionnaire (GHQ-28)IES, LH, FSH,SHBGPhysicosocial Adjustment to Illness scale(PAIS) 43 NA Eur J Cancer

Özen et al. 1998 various

General Health questionnaire-28general survey 140 NA J Urol

Arai et al. 1996 Chemo±RPLND,RT,Surveillance

psycosocial well-beingworking abilitySatisfactionRelationshipgeneral health and fitness 83 NA J Urol

Stuart et al. 1990 Chemo, RT

General health subjective side effectEmploymentRelationshipreproduction and mood 62 NA Eur J Cancer

Tamburini et al. 1989 Chemo,RPLND, combination, RT

Spitzer QL- indexwork activitiesemotional relationship 31 NA J Urol

Çalışma Önerileri

• KESİTSEL ÇALIŞMA

BÖBREK TÜMÖRÜ HAYAT KALİTESİDr. Cenk Acar

Pamukkale Üniversitesi

Üroloji Anabilim Dalı

Literatür Taraması

• Böbrek Tm. Hayat Kalitesi

• 2002-2011 tarihleri arasında

▫ 8 orijinal makale

Author Year Patient Groups

HRQoL InstrumentsPatientNumber

Follow-up(year) Journal

Novaraet al.

2010Radical nephrectomy (open andlap) vs partial nx

sf-36Postoperative 6. and 12. mo

129 NA Eur Urol

Beemsteret al. 201o Laparoscopic cryoablation

SF-36eortc qlqc30VASBaseline and 1 year 57 NA J Endourol

Gratzkeet al. 2009

Retro radical nx, Open rad nx, partial nx

Sf-36117 2 BJU Int

Onishi et al. 2007 percutaneous RFA, Lap radical nx

SF-36Pre and post-operatively(1,4,12 and 24 weeks) 37 NA Jpn J Clin Oncol

Dillenburg et al. 2006

Retro rad nx vs open rad nx (T2 and T3a) 48 1 Eur Urol

Patel et al. 2005

Retro rad nx vs hand assisted radnx

sf-363 an 6 mo after surgery

51 NA J Endourol

Poulakiset al. 2003 Radical nx vs partial nx

SF-36Eortc qlqc30Fear, stress and worry 357 At least 1 year Urology

Ficarra V 2003Radical nx vs partial nx

SF-36

88 NA Int Urol Nephrol

Çalışma Önerileri

• KESİTSEL ÇALIŞMA