Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States

Usama Jazzar, Shan Yong, Zachary Klaassen, Jinhai Huo, Byron D. Hughes, Edgar Esparza, Hemalkumar B. Mehta, Simon P. Kim, Douglas S. Tyler, Stephen J. Freedland, Ashish M. Kamat, Dwight V. Wolf, Stephen B. Williams

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Abstract

BACKGROUND: Treatments for muscle-invasive bladder cancer are multimodal, complex, and often carry significant risks of physical and psychological morbidity. The objectives of this study were to define the incidence and types of psychiatric illnesses diagnosed after treatment and to determine their impact on survival outcomes. METHODS: In total, 3709 patients who were diagnosed with clinical stage T2 through T4a bladder cancer from January 1, 2002, to December 31, 2011, from the Surveillance, Epidemiology, and End Results-Medicare were analyzed. Multivariable analysis and Cox proportional-hazards models were used to determine the predictors associated with psychiatric diagnosis and impact on survival outcomes. RESULTS: Of 3709 patients, 1870 (50.4%) were diagnosed with posttreatment psychiatric disorders. Patients who underwent radical cystectomy were identified as being at significantly greater risk of having a posttreatment psychiatric illness compared with those who received radiotherapy and/or chemotherapy (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.07-1.31; P =.001). In adjusted analyses, diagnosis of a psychiatric disorder resulted in significantly worse overall survival (HR, 2.80; 95% CI, 2.47-3.17; P <.001) and cancer-specific survival (HR, 2.39; 95% CI, 2.05-2.78; P <.001). CONCLUSIONS: One-half of patients with muscle-invasive bladder cancer who underwent treatment were diagnosed with a psychiatric disorder, which resulted in worse survival outcomes compared with patients who did not have a posttreatment psychiatric diagnosis. This information can be used to inform interventions to educate patients with muscle-invasive bladder cancer regarding the impact of different treatments on mental health. Cancer 2018.

Original languageEnglish (US)
Pages (from-to)3127-3135
Number of pages9
JournalCancer
Volume124
Issue number15
DOIs
StatePublished - Aug 1 2018

Fingerprint

Urinary Bladder Neoplasms
Psychiatry
Survival
Mental Disorders
Confidence Intervals
Muscles
Cystectomy
Therapeutics
Medicare
Proportional Hazards Models
Neoplasms
Mental Health
Epidemiology
Radiotherapy
Psychology
Morbidity
Drug Therapy
Incidence

Keywords

  • Epidemiology
  • Surveillance
  • and End Results (SEER)
  • bladder cancer
  • depression
  • mortality
  • psychiatric
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Jazzar, U., Yong, S., Klaassen, Z., Huo, J., Hughes, B. D., Esparza, E., ... Williams, S. B. (2018). Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States. Cancer, 124(15), 3127-3135. https://doi.org/10.1002/cncr.31404

Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States. / Jazzar, Usama; Yong, Shan; Klaassen, Zachary; Huo, Jinhai; Hughes, Byron D.; Esparza, Edgar; Mehta, Hemalkumar B.; Kim, Simon P.; Tyler, Douglas S.; Freedland, Stephen J.; Kamat, Ashish M.; Wolf, Dwight V.; Williams, Stephen B.

In: Cancer, Vol. 124, No. 15, 01.08.2018, p. 3127-3135.

Research output: Contribution to journalArticle

Jazzar, U, Yong, S, Klaassen, Z, Huo, J, Hughes, BD, Esparza, E, Mehta, HB, Kim, SP, Tyler, DS, Freedland, SJ, Kamat, AM, Wolf, DV & Williams, SB 2018, 'Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States', Cancer, vol. 124, no. 15, pp. 3127-3135. https://doi.org/10.1002/cncr.31404
Jazzar, Usama ; Yong, Shan ; Klaassen, Zachary ; Huo, Jinhai ; Hughes, Byron D. ; Esparza, Edgar ; Mehta, Hemalkumar B. ; Kim, Simon P. ; Tyler, Douglas S. ; Freedland, Stephen J. ; Kamat, Ashish M. ; Wolf, Dwight V. ; Williams, Stephen B. / Impact of psychiatric illness on decreased survival in elderly patients with bladder cancer in the United States. In: Cancer. 2018 ; Vol. 124, No. 15. pp. 3127-3135.
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abstract = "BACKGROUND: Treatments for muscle-invasive bladder cancer are multimodal, complex, and often carry significant risks of physical and psychological morbidity. The objectives of this study were to define the incidence and types of psychiatric illnesses diagnosed after treatment and to determine their impact on survival outcomes. METHODS: In total, 3709 patients who were diagnosed with clinical stage T2 through T4a bladder cancer from January 1, 2002, to December 31, 2011, from the Surveillance, Epidemiology, and End Results-Medicare were analyzed. Multivariable analysis and Cox proportional-hazards models were used to determine the predictors associated with psychiatric diagnosis and impact on survival outcomes. RESULTS: Of 3709 patients, 1870 (50.4{\%}) were diagnosed with posttreatment psychiatric disorders. Patients who underwent radical cystectomy were identified as being at significantly greater risk of having a posttreatment psychiatric illness compared with those who received radiotherapy and/or chemotherapy (hazard ratio [HR], 1.19; 95{\%} confidence interval [CI], 1.07-1.31; P =.001). In adjusted analyses, diagnosis of a psychiatric disorder resulted in significantly worse overall survival (HR, 2.80; 95{\%} CI, 2.47-3.17; P <.001) and cancer-specific survival (HR, 2.39; 95{\%} CI, 2.05-2.78; P <.001). CONCLUSIONS: One-half of patients with muscle-invasive bladder cancer who underwent treatment were diagnosed with a psychiatric disorder, which resulted in worse survival outcomes compared with patients who did not have a posttreatment psychiatric diagnosis. This information can be used to inform interventions to educate patients with muscle-invasive bladder cancer regarding the impact of different treatments on mental health. Cancer 2018.",
keywords = "Epidemiology, Surveillance, and End Results (SEER), bladder cancer, depression, mortality, psychiatric, survival",
author = "Usama Jazzar and Shan Yong and Zachary Klaassen and Jinhai Huo and Hughes, {Byron D.} and Edgar Esparza and Mehta, {Hemalkumar B.} and Kim, {Simon P.} and Tyler, {Douglas S.} and Freedland, {Stephen J.} and Kamat, {Ashish M.} and Wolf, {Dwight V.} and Williams, {Stephen B.}",
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AU - Jazzar, Usama

AU - Yong, Shan

AU - Klaassen, Zachary

AU - Huo, Jinhai

AU - Hughes, Byron D.

AU - Esparza, Edgar

AU - Mehta, Hemalkumar B.

AU - Kim, Simon P.

AU - Tyler, Douglas S.

AU - Freedland, Stephen J.

AU - Kamat, Ashish M.

AU - Wolf, Dwight V.

AU - Williams, Stephen B.

PY - 2018/8/1

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N2 - BACKGROUND: Treatments for muscle-invasive bladder cancer are multimodal, complex, and often carry significant risks of physical and psychological morbidity. The objectives of this study were to define the incidence and types of psychiatric illnesses diagnosed after treatment and to determine their impact on survival outcomes. METHODS: In total, 3709 patients who were diagnosed with clinical stage T2 through T4a bladder cancer from January 1, 2002, to December 31, 2011, from the Surveillance, Epidemiology, and End Results-Medicare were analyzed. Multivariable analysis and Cox proportional-hazards models were used to determine the predictors associated with psychiatric diagnosis and impact on survival outcomes. RESULTS: Of 3709 patients, 1870 (50.4%) were diagnosed with posttreatment psychiatric disorders. Patients who underwent radical cystectomy were identified as being at significantly greater risk of having a posttreatment psychiatric illness compared with those who received radiotherapy and/or chemotherapy (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.07-1.31; P =.001). In adjusted analyses, diagnosis of a psychiatric disorder resulted in significantly worse overall survival (HR, 2.80; 95% CI, 2.47-3.17; P <.001) and cancer-specific survival (HR, 2.39; 95% CI, 2.05-2.78; P <.001). CONCLUSIONS: One-half of patients with muscle-invasive bladder cancer who underwent treatment were diagnosed with a psychiatric disorder, which resulted in worse survival outcomes compared with patients who did not have a posttreatment psychiatric diagnosis. This information can be used to inform interventions to educate patients with muscle-invasive bladder cancer regarding the impact of different treatments on mental health. Cancer 2018.

AB - BACKGROUND: Treatments for muscle-invasive bladder cancer are multimodal, complex, and often carry significant risks of physical and psychological morbidity. The objectives of this study were to define the incidence and types of psychiatric illnesses diagnosed after treatment and to determine their impact on survival outcomes. METHODS: In total, 3709 patients who were diagnosed with clinical stage T2 through T4a bladder cancer from January 1, 2002, to December 31, 2011, from the Surveillance, Epidemiology, and End Results-Medicare were analyzed. Multivariable analysis and Cox proportional-hazards models were used to determine the predictors associated with psychiatric diagnosis and impact on survival outcomes. RESULTS: Of 3709 patients, 1870 (50.4%) were diagnosed with posttreatment psychiatric disorders. Patients who underwent radical cystectomy were identified as being at significantly greater risk of having a posttreatment psychiatric illness compared with those who received radiotherapy and/or chemotherapy (hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.07-1.31; P =.001). In adjusted analyses, diagnosis of a psychiatric disorder resulted in significantly worse overall survival (HR, 2.80; 95% CI, 2.47-3.17; P <.001) and cancer-specific survival (HR, 2.39; 95% CI, 2.05-2.78; P <.001). CONCLUSIONS: One-half of patients with muscle-invasive bladder cancer who underwent treatment were diagnosed with a psychiatric disorder, which resulted in worse survival outcomes compared with patients who did not have a posttreatment psychiatric diagnosis. This information can be used to inform interventions to educate patients with muscle-invasive bladder cancer regarding the impact of different treatments on mental health. Cancer 2018.

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KW - Surveillance

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KW - mortality

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