Table 2.

Summary of key studies evaluating health-related quality of life in individuals with localised renal cancer undergoing surgical management

Study	Sample size (N)	Surgery type	Timing of QoL assessment	Questionnaire	Key findings
Laparoscopic vs open surgery
Burgess et al. [18]	N = 45	LRN vs ORN	Baseline, 3 and 12 months	EQ-5D VAS pain score	LRN: significantly reduced post-operative pain and faster return to normal daily activities EQ-5D data was not significant therefore not reported
Harryman et al. [21]	N = 100 Only 71 patients completed all assessments	LN vs ON	Baseline, 2 days and 1 month	SF-36 VAS pain score	LN: significantly better PCS, MCS and reduced pain
Kim et al. [8]	N = 71 Only 60 patients completed questionnaire at baseline and at least one other time point	ON, LN and robotic assisted nephrectomy	Baseline, 2, 4, 12, and 24 weeks	CARE SF-12	Study not powered to allow comparisons amongst patients undergoing different surgical management options
Parker et al. [19]	N = 172 Only 64 patients completed all assessments	LRN, LPN, ORN, OPN	Baseline, 3 weeks, 2, 3, 6, and 12 months	SF-36 CARES-SF IES Fear of recurrence	LN vs ON: LN associated with significantly better PCS, quicker return to baseline, but short term benefit only RN vs PN: RN associated with significantly better cancer-specific QoL No difference in MCS, IES and fear of recurrence between surgery types Post-operative GFR was significantly associated with PCS, IES and fear of recurrence
Acar et al. [20]	N = 72	LRN vs ORN	Baseline, 1 and 6 months	SF-36 VAS pain score	LRN: shorter hospital stay, earlier ambulation and better general health perception VAS pain scores were similar
Becker et al. [28]	N = 110	LPN vs OPN	Median: 49 months	EORTC-QLQ-C30	No significant difference in post-operative HRQoL in the two groups
Nephron-sparing vs radical surgery
Clark et al. [22]	N = 97	PN vs RN	NR	SF-36 IES-R Fear of recurrence	Patients’ perception of remaining renal function, rather than surgery type, was a significant and independent predictor HRQoL Self-reporting less renal function: worse PCS and IES, more negative thoughts regarding cancer recurrence and reduced renal function
Shinohara et al. [26]	N = 50	PN vs RN		EORTC-QLQ-C30	PN: significantly better physical function, less pain, fatigue, sleep disturbance and constipation
Ficarra et al. [23]	N = 144	PN vs RN	Median: 55 ± 36 months	GHQ HADS SPQ List of threatening experiences	PN: significantly lower levels of anxiety and depression No significant difference in other domains
Poulakis et al. [24]	N = 357	PN vs RN	NR	SF-36 EORTC-QLQ-C30 IES-R Fear of recurrence Worry about having fewer than two normal kidneys	PN: significantly better physical function, role functioning and less pain and fatigue No difference in IES and fear of recurrence
Gratzke et al. [27]	N = 117 Only 84 patients completed assessments	RRN vs ORN vs OPN	Mean: 22 months	SF-36	No significant difference between HRQoL in the three surgical groups
Novara et al. [29]	N = 129	PN vs RN	Baseline, 6 and 12 months	SF-36	Type of surgery did not affect return to baseline Following operative management for RCC, physical function may be worse than the reference population due to the insult of surgery, but emotional and psychological wellbeing is higher as the tumour has been removed
Azawi et al. [25]	N = 152	PN vs RN	Three cohorts: < 2 years from surgery, 2–4 and > 4 years	EORTC-QLQ-C30 RQRC	PN: significantly better global QoL, physical function, role functioning and less fatigue

CARES-SF Cancer Rehabilitation Evaluation System-Short Form, EORTC-QLQ-C30 European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, GHQ General Health Questionnaire, HADS Hospital Anxiety and Depression Scale, IES-R Impact of Events Scale Revised, LPN laparoscopic partial nephrectomy; LRN laparoscopic radical nephrectomy, MCS mental component score on SF-36, NR Not reported, OPN open partial nephrectomy, ORN open radical nephrectomy, PCS physical component score on SF-36, QoL Quality of life; RQRC Rehabilitation Questionnaire for Renal Cancer, RRN retroperitoneoscopic radical nephrectomy, SF-12 Short Form 12, SF-36 Short Form 36, SPQ Social Problem Questionnaire, VAS Visual Analogue Scale