Health-Related Quality of Life after Radical Cystectomy for Bladder Cancer in Elderly Patients with Ileal Orthotopic Neobladder or Ileal Conduit: Results from a Multicentre Cross-Sectional Study Using Validated Questionnaires

Maria Angela Cerruto, Carolina D'Elia, Salvatore Siracusano, Omar Saleh, Mauro Gacci, Giovanni Cacciamani, Vincenzo De Marco, Antonio Benito Porcaro, Matteo Balzarro, Mauro Niero, Cristina Lonardi, Massimo Iafrate, Pierfrancesco Bassi, Ciro Imbimbo, Marco Racioppi, Renato Talamini, Stefano Ciciliato, Sergio Serni, Marco Carini, Paolo VerzeWalter Artibani

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate health-related quality of life (HR-QoL) outcomes in elderly patients with different type of urinary diversion (UD), ileal conduit (IC) and ileal orthotopic neobladder (IONB), after radical cystectomy (RC) for bladder cancer, by using validated self-reported cancer-specific instruments. Patients and Methods: We retrospectively reviewed 77 patients who received an IC or an IONB after RC. HR-QoL was assessed with specific and validated disease questionnaires, administered at last follow-up. Result: At univariate analysis, at a mean follow-up of 60.91 ± 5.63 months, IONB results were favourable with regard to the following HR-QoL aspects: nausea and vomiting (p = 0.045), pain (p = 0.049), appetite loss (p = 0.03), constipation (p = 0.000), financial impact (p = 0.012) and cognitive functioning (p = 0.000). This last functional aspect was significantly worse in female patients (p = 0.029). Emotional functioning was significantly better in patients without long-term complications (p = 0.016). At multivariate analysis, male gender and IONB were independent predictors of better cognitive functioning, while long-term complications negatively affected emotional functioning. Conclusions: Obtained results suggest that an IONB can also be suitable for elderly patients compared with an IC with few and selected advantages in favour of the former UD. Preoperative patient's selection, counselling, education and active participation in the decision-making process lead to a more suitable choice of treatment.

Original languageEnglish
Pages (from-to)346-352
Number of pages7
JournalUrologia Internationalis
Volume100
Issue number3
DOIs
Publication statusPublished - Apr 1 2018

Keywords

  • Bladder cancer
  • Ileal conduit
  • Orthotopic neobladder
  • Quality of life
  • Radical cystectomy
  • Urinary diversions

ASJC Scopus subject areas

  • Urology

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