Quality of life following urinary diversion: Orthotopic ileal neobladder versus ileal conduit. A multicentre study among long-term, female bladder cancer survivors

Women undergoing radical cystectomy (RC) followed by urinary diversion (UD) for bladder cancer experience a substantial reduction in health-related quality of life (HRQOL). At present, studies comparing long-term QOL outcomes for different UD methods, needed to inform evidence-based choices of bladder reconstruction for female patients, are sparse. Our objective was to compare two common UD methods in terms of their HRQOL outcomes in women.

We retrospectively analysed HRQOL in 73 consecutive female bladder cancer patients having undergone orthotopic ileal neobladder (IONB, N = 24) or ileal conduit (IC, N = 49) following RC between 2007 and 2013 in six Italian academic urological centres. Patients had no evidence of tumour recurrence and were actively followed up. Validated Italian versions of the European Organisation for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder-cancer-specific (QLQ-BLM30) questionnaires were used to evaluate HRQOL.

Patients in the IONB group were significantly younger than those in the IC group (median age: 67 and 73 years, respectively, p = 0.02). Barring that, the two groups did not present statistically significant differences in median length of follow-up (43 vs 54 months), pathological stage, grading of the neoplasm, or adjuvant chemo - or radiotherapy. No significant differences in QOL were found between the groups, with the exception of financial difficulties, affecting IONB patients significantly more than IC patients (mean score on a scale of 0-100: 33.3 ± 29.5 vs 18.4 ± 19.3, respectively; p = 0.05).

Financial difficulties was the only HRQOL item to differ between the two UD groups.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2018 Oct 21 [Epub ahead of print]

Salvatore Siracusano, Carolina D'Elia, Maria Angela Cerruto, Mauro Gacci, Stefano Ciciliato, Alchiede Simonato, Antonio Porcaro, Vincenzo De Marco, Renato Talamini, Laura Toffoli, Omar Saleh, Sergio Serni, Francesco Visalli, Mauro Niero, Cristina Lonardi, Ciro Imbimbo, Paolo Verze, Vincenzo Mirone, Marco Racioppi, Massimo Iafrate, Giovanni Cacciamani, Davide De Marchi, Pierfrancesco Bassi, Walter Artibani

University of Verona, Urology Department, Verona, Italy., Bolzano General Hospital, Bolzano, Italy. Electronic address: ., Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy., Trieste University, Urology Department, Trieste, Italy., University of Genoa, Department of Urology, IRCSS San Martino - IST, Genoa, Italy., IRCCS-CRO, Unit of Epidemiology and Biostatistics, Aviano, Italy., University of Verona, Human Sciences Department, Verona, Italy., Department of Neurosciences, Reproductive Sciences, Odontostomatology, Urology Unit, University of Naples, Italy., Catholic University of Rome, Policlinico Gemelli, Urology Department, Rome, Italy., University of Padua, Urology Department, Padua, Italy.