【Abstract】Objective To analyze and compare the quality of life (QoL) before and after surgery in elderly patients with bladder tumors and to evaluate the influencing factors of poor QoL. Methods A prospective questionnaire survey was conducted on 158 elderly patients with non-muscle invasive bladder cancer (NMIBC), who received transurethral resection of bladder tumor (TURBT) in People′ s Hospital of Xinjiang Uygur Autonomous Region from June 2021 to September 2023. European Organization for Research and Treatment of Cancer-Quality of Life in superficial bladder cancer patients (EORTC QLQ-BLS24) was used to evaluate the patients′ QoL before surgery, and at 1 month and 3 months after surgery. Finally, 147 patients completed questionnaires three times. The total EORTC QLQ-BLS24 score in the 147 elderly NMIBC patients was (160.72±17.43) points at 1 month after surgery. According to this score, the patients were divided into a good QoL group (total QLQ-BLS24 score ≤ average, n=75) and a poor QoL group (total QLQ-BLS24 score > average, n=72). The two groups were compared in general data including gender, age, and preoperative geriatric nutritional risk index (GNRI). SPSS 26.0 was used for statistical analysis. Comparison between two groups was performed using t test, Chi-square test or Fisher′s exact probability method depending on data type. Logistic regression analysis was used to evaluate the influencing factors of poor QoL in elderly NMIBC patients at 1 month after TURBT. Results At 1 month after TURBT, the scores of urinary tract symptom, treatment problems, intestinal symptom, sexual function, and total scores of EORTC QLQ-BLS24 in elderly NMIBC patients were significantly higher than those before surgery and at 3 months after surgery (P<0.05), and the score of worrying about the future was lower than that before surgery (P<0.05), but was higher than that at 3 months after surgery (P<0.05). There were statistically significant differences in preoperative GNRI, intravesical instillation regimen, adverse reactions to intravesical instillation, and anxiety between the poor QoL group and good QoL group (P<0.05). Logistic regression analysis showed that preoperative GNRI≤98 (OR=3.397,95%CI 2.073-5.567; P<0.05), adverse reactions to intravesical instillation (OR=2.776,95%CI 1.517-5.081; P<0.05) and anxiety (OR=2.326,95%CI 1.186-4.560; P<0.05) were risk factors for poor QoL at 1 month after TURBT. Gemcitabine intravesical instillation was a protective factor (OR=0.566,95%CI 0.013-0.924; P<0.05). Conclusion QoL in elderly NMIBC patients declines initially at 1 month after TURBT and improves by 3 months. Preoperative GNRI≤98, adverse reactions to intravesical instillation, and anxiety are risk factors for poor postoperative QoL. Gemcitabine intravesical instillation can improve postoperative QoL.
