TY - JOUR
T1 - Health-related Quality of Life After Radical Cystectomy: A Cross-sectional Study With Matched-pair Analysis on Ileal Conduit vs Ileal Orthotopic Neobladder Diversion
AU - Cerruto, Maria Angela
AU - D'Elia, Carolina
AU - Siracusano, Salvatore
AU - Saleh, Omar
AU - Gacci, Mauro
AU - Cacciamani, Giovanni
AU - De Marco, Vincenzo
AU - Porcaro, Antonio Benito
AU - Balzarro, Matteo
AU - Niero, Mauro
AU - Lonardi, Cristina
AU - Iafrate, Massimo
AU - Bassi, Pierfrancesco
AU - Imbimbo, Ciro
AU - Racioppi, Marco
AU - Talamini, Renato
AU - Ciciliato, Stefano
AU - Serni, Sergio
AU - Carini, Marco
AU - Verze, Paolo
AU - Artibani, Walter
PY - 2017
Y1 - 2017
N2 - Objective To examine the different and health-related quality of life (HR-QoL) outcomes between ileal conduit (IC) and ileal orthotopic neobladder (IONB) in patients who underwent radical cystectomy (RC), by using validated self-reported cancer-specific instruments. Patients and Methods This retrospective, cross-sectional, multicenter cohort study included 148 and 171 patients with either IC or IONB. HR-QoL was evaluated with Quality of Life Core Questionnaire and bladder module (BLM)-30 European Organisation for Research and Treatment of Cancer questionnaires. Baseline HR-QoL scores were dichotomized at the median to give “good” or “poor” score profiles. A matched-pair analysis compared HR-QoL aspects between 79 IC patients and 79 IONB patients. Results At univariate analysis IONB resulted favorable for physical functioning, emotional functioning, cognitive functioning (CF), fatigue, dyspnea, appetite loss, constipation (CO), and abdominal bloating flatulence (AB). At multivariate analyses, IONB showed better scores for emotional functioning (85 vs 79, P =.023), CF (93 vs 85, P <.001), CO (16 vs 31, P <.001), and AB (12 vs 25, P <.001). A significant worsening of sexual and urinary function was observed for IONB patients in the long-term. At matched-pair analysis, global health status was similar (65 vs 62, P =.385). Significantly better scores were observed in the IONB group for the following items: CF (P =.007), fatigue (P =.003), pain (P =.019), dyspnea (P =.016), CO (P =.001), and AB (P =.00). Conclusion IONB and IC after RC were similar in terms of global health status. IONB provides better results in some aspects of HR-QoL related to bowel function, but a worsening of urinary and sexual functions. Further randomized controlled trials are needed to confirm these data.
AB - Objective To examine the different and health-related quality of life (HR-QoL) outcomes between ileal conduit (IC) and ileal orthotopic neobladder (IONB) in patients who underwent radical cystectomy (RC), by using validated self-reported cancer-specific instruments. Patients and Methods This retrospective, cross-sectional, multicenter cohort study included 148 and 171 patients with either IC or IONB. HR-QoL was evaluated with Quality of Life Core Questionnaire and bladder module (BLM)-30 European Organisation for Research and Treatment of Cancer questionnaires. Baseline HR-QoL scores were dichotomized at the median to give “good” or “poor” score profiles. A matched-pair analysis compared HR-QoL aspects between 79 IC patients and 79 IONB patients. Results At univariate analysis IONB resulted favorable for physical functioning, emotional functioning, cognitive functioning (CF), fatigue, dyspnea, appetite loss, constipation (CO), and abdominal bloating flatulence (AB). At multivariate analyses, IONB showed better scores for emotional functioning (85 vs 79, P =.023), CF (93 vs 85, P <.001), CO (16 vs 31, P <.001), and AB (12 vs 25, P <.001). A significant worsening of sexual and urinary function was observed for IONB patients in the long-term. At matched-pair analysis, global health status was similar (65 vs 62, P =.385). Significantly better scores were observed in the IONB group for the following items: CF (P =.007), fatigue (P =.003), pain (P =.019), dyspnea (P =.016), CO (P =.001), and AB (P =.00). Conclusion IONB and IC after RC were similar in terms of global health status. IONB provides better results in some aspects of HR-QoL related to bowel function, but a worsening of urinary and sexual functions. Further randomized controlled trials are needed to confirm these data.
KW - Aged
KW - Cross-Sectional Studies
KW - Cystectomy
KW - Female
KW - Follow-Up Studies
KW - Health Status
KW - Humans
KW - Male
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Quality of Life
KW - Retrospective Studies
KW - Surveys and Questionnaires
KW - Treatment Outcome
KW - Urinary Bladder
KW - Urinary Bladder Neoplasms
KW - Urinary Diversion
KW - Urinary Reservoirs, Continent
KW - Urination
KW - Aged
KW - Cross-Sectional Studies
KW - Cystectomy
KW - Female
KW - Follow-Up Studies
KW - Health Status
KW - Humans
KW - Male
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Quality of Life
KW - Retrospective Studies
KW - Surveys and Questionnaires
KW - Treatment Outcome
KW - Urinary Bladder
KW - Urinary Bladder Neoplasms
KW - Urinary Diversion
KW - Urinary Reservoirs, Continent
KW - Urination
UR - http://hdl.handle.net/10807/170809
U2 - 10.1016/j.urology.2017.06.022
DO - 10.1016/j.urology.2017.06.022
M3 - Article
SN - 0090-4295
VL - 108
SP - 82
EP - 89
JO - Urology
JF - Urology
ER -