Patient Preferences for Post-Radical Cystectomy Treatment in Muscle-Invasive Bladder Cancer: A Discrete Choice...

Area of Science:

• Urology
• Oncology
• Health Economics

Background:

• Muscle-invasive bladder cancer (MIBC) is a significant clinical challenge.
• Radical cystectomy is a primary treatment for MIBC.
• Understanding patient preferences is crucial for shared decision-making.

Purpose of the Study:

• To assess treatment preferences of Japanese MIBC patients post-radical cystectomy.
• To quantify trade-offs between treatment attributes using a discrete choice experiment (DCE).
• To inform personalized treatment selection based on patient values.

Main Methods:

• A discrete choice experiment (DCE) was conducted with 101 MIBC patients.
• Participants evaluated hypothetical treatments based on efficacy (disease-free survival), side effects, administration, and cost.
• Analysis included relative importance (RI), maximum acceptable risk (MAR), and willingness to trade efficacy (WTTE).

Main Results:

• Disease-free survival (DFS) was the most important attribute (RI: 30.3%), followed by annual cost (27.7%) and severe side effects risk (26.8%).
• Patients accepted increased side effect risk for improved DFS but were sensitive to severity and cost, often trading DFS for better risk/cost profiles.
• Subgroup analyses showed consistent trends, with variations in attribute importance based on patient characteristics like age and employment.

Conclusions:

• This study provides the first insights into Japanese MIBC patient preferences post-radical cystectomy.
• Patient preferences significantly influence choices regarding efficacy, cost, and side effects.
• These findings can guide clinicians in tailoring treatment strategies to individual patient values.