OBJECTIVE:To determine the short-term health status of patients after robot-assisted radical cystectomy using the Convalescence and Recovery Evaluation (CARE).
Radical cystectomy and urinary diversion in patients with invasive bladder cancer can have a significant effect on patients' quality of life.
METHODS: A total of 91 patients completed the CARE preoperatively and postoperatively. The CARE scores were calculated from postoperative day 7 to 90. Outcome measures were calculated using the CARE difference index (CDI), defined as the difference between the baseline CARE and postoperative day 7 CARE scores. The primary outcome was the time taken to recover 90% of the CDI.
RESULTS: The mean age at robot-assisted radical cystectomy was 69 years (range 42-86). Of the 91 patients, 68 (74%) were men, 38 underwent extracorporeal urinary diversion, 52 underwent intracorporeal urinary diversion, and 1 underwent no diversion. A comparison of the preoperative and postoperative day 7 scores demonstrated a 48% decline in the total CARE score. The decline in specific CARE domains was 14%, 34%, 56%, and 66% against baseline for the cognition, pain, gastrointestinal, and activity domains, respectively. The mean time to recover 90% of the CDI for the total CARE score was 63 days. The mean time to recover 90% of the CDI for the pain, cognition, and activity domains was 33, 57, and 82 days, respectively. Patients did not recover 90% of the CDI for the gastrointestinal domain within the 90-day follow-up period.
CONCLUSION: Patients who underwent robot-assisted radical cystectomy approached preoperative baseline levels within 90 days using the CARE in the total CARE, pain, cognition, and activity domains but not in the gastrointestinal domain.
Written by:
Stegemann A, Rehman S, Brewer K, Kesavadas T, Hussain A, Chandrasekhar R, Wilding GE, Guru KA. Are you the author?
Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.
Reference: Urology. 2012 Jun;79(6):1274-80.
doi: 10.1016/j.urology.2011.12.062
PubMed Abstract
PMID: 22521192
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