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

Abstract

Objectives: This study aimed to assess the treatment preferences of Japanese patients with muscle-invasive bladder cancer (MIBC) by quantifying their trade-offs between treatment attributes using a discrete choice experiment (DCE).

Methods: A DCE was conducted among MIBC patients post-radical cystectomy. Participants were presented with hypothetical treatment options differing in attributes such as efficacy Disease-free survival (DFS), side effects, administration, and cost. Preference data were analyzed to determine each attribute's relative importance (RI), maximum acceptable risk (MAR), and willingness to trade efficacy (WTTE).

Results: Out of 105 patients surveyed, 101 were included in the final analysis. The DCE revealed that DFS had the highest RI (30.3%), followed by annual treatment cost (27.7%) and risk of severe side effects (26.8%). While MAR analysis indicated that patients were willing to accept some increase in side effects risk for significant gains in DFS, WTTE results showed a sensitivity to side effect severity and treatment costs, with patients often willing to trade off DFS for improvements in risks and costs. In subgroup analyses, such as pathological stage, age, and employment status, the trends for each subgroup were the same as those of the overall population. However, the magnitude of RI varied among patients with different characteristics. For example, younger patients preferred short-term treatment duration over longer, employed patients tended to favor long-term treatment duration.

Conclusions: This study is the first to demonstrate the treatment preferences of Japanese MIBC patients who underwent radical cystectomy, and these results can inform treatment selection based on patient preferences.

Trial registration: Japan Registry of Clinical Trials: jRCT1030220680.