Prospective health-related quality of life analysis for patients undergoing radical cystectomy and urinary diversion.

Abstract

OBJECTIVE:

To better define health-related quality of life (HRQOL) for patients undergoing radical cystectomy (RC) and urinary diversion.

MATERIALS AND METHODS:

Patients undergoing RC and urinary diversion for urothelial carcinoma by 1 of 2 surgeons (G.D.S. or N.D.S.) had a HRQOL assessment at baseline and at follow-up using the validated, bladder cancer-specific Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index questionnaire. The primary outcome was change in HRQOL between baseline and follow-up.

RESULTS:

From September 15, 2011, to July 23, 2012, 74 of 103 eligible patients were enrolled, and all but 1 completed the baseline Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index leaving 73 patients in the study. Median age was 68 years (interquartile range, 60-74 years), 58 (78%) were Caucasian, 53 (73%) were ≥ cT2, 45 (62%) underwent incontinent diversion, and the mean age-adjusted Charlson Comorbidity Index score was 2.4 ± 1.8, with no significant differences among the 73 participants and 30 nonparticipants. The median time from surgery to response was 175 days (interquartile range, 102-232 days), and the response rate was 67%, with 9 deaths during follow-up. Baseline HRQOL scores did not significantly differ between respondents and nonrespondents or between those living vs deceased. Overall, RC-specific, physical, social, and functional HRQOL scores did not differ from baseline to follow-up, whereas emotional HRQOL scores were significantly improved (15.7 ± 5.8 vs 18.1 ± 3.9, P = .03). Overall or domain-specific HRQOL measures did not differ significantly between patients undergoing incontinent (n = 27) vs continent (n = 16) diversions.

CONCLUSION:

Overall, HRQOL scores did not statistically differ from baseline to the median 6-month follow-up for patients undergoing RC and urinary diversion for urothelial carcinoma. Patients undergoing continent vs incontinent urinary diversions had similar overall HRQOL scores at follow-up.

• Authors: Michael C Large, Rena Malik, Joshua A Cohn, Kyle A Richards, Cory Ganshert, Rangesh Kunnavakkum, Norm D Smith, Gary D Steinberg
• Journal: Urology (Urology) Vol. 84 Issue 4 Pg. 808-13 (Oct 2014) ISSN: 1527-9995 [Electronic] United States
• PMID: 25109565 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Cystectomy
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Prospective Studies
• Quality of Life
• Urinary Diversion