Prospective evaluation of return to work, health-related quality of life and psychosocial distress after radical cystectomy

\ (Purpose\) To evaluate return to work (RTW), health-related quality of life (HRQoL) and psychosocial distress (PD) after radical cystectomy (RC) and creation of an ileal conduit (IC) or an orthotopic ileal neobladder (NB) for bladder cancer. \ (Methods\) The study relied on prospectively collected data for 842 patients, who underwent 3 weeks of inpatient rehabilitation (IR) after surgery between April 2018 and December 2019. HRQoL (EORTC QLQ-C30) and PD (Questionnaire on Stress in Cancer Patients QSC-R10) were evaluated at the beginning (T1) and end (T2) of IR as well as both 6 (T3) and 12 months after surgery (T4). Regression analyses were performed to identify predictors of HRQoL and RTW, respectively. \ (Results\) Two hundred thirty patients (IC \ (n\) = 51, NB \ (n\) = 179) were employed before surgery (27. 3%). HRQoL improved steadily, while high PD was present in 51. 0% of patients at T4. RTW rate was 86. 8 and 80. 6% at T3 and T4, respectively. Linear regression analysis identified RTW as the only predictor for better HRQoL at T4 (OR odds ratio 12. 823, 95% CI confidence interval 2. 927–22. 720, \ (p\) = 0. 012). Multivariate regression analysis identified age \ (\) 59 years (OR 7. 842; 95% CI 2. 495–24. 645; \ (p\) < 0. 001) as an independent positive predictor and lymph node metastasis (OR 0. 220; 95% CI 0. 054–0. 893; \ (p\) = 0. 034) as an independent negative predictor of RTW at T4. \ (Conclusion\) Global HRQoL improved steadily during the follow-up and RTW rates are high. However, patients often reported high PD, reflecting a need for additional psychosocial support within aftercare.