Health-Related Quality of Life after Radical Cystectomy: A Cross Sectional Study with Matched Pair Analysis on Ileal Conduit Versus Ileal Orthotopic Neobladder Diversion

To examine the different and Health-Related Quality of Life (HR-QoL) outcomes between ileal conduit (IC) vs. ileal-orthotopic-neobladder (IONB) in patients who underwent RC for primary BC, by using validated self-reported cancer-specific instruments.

This retrospective, cross sectional, multicentre cohort study included 148 and 171 patients who underwent RC with either IC or IONB with curative intent. HR-QoL was evaluated with QLQ.C-30 and BLM-30 EORTC questionnaires. Baseline HRQoL scores were dichotomized at the median to give "good" or "poor" score's profiles. A matched-pair comparative analysis was performed for comparison of HR-QoL aspects between 79 IC vs. 79 IONB patients.

Univariate analyses showed significant differences favouring IONB in: physical functioning(PhF), emotional functioning(EF), cognitive functioning(CF), fatigue(FA), dyspnoea(DY), appetite loss(AL), constipation(CO), and abdominal bloating flatulence(AB). At multivariate analyses IONB showed better scores for EF (85vs.79, p=0.023), CF (93vs.85, p<0.001), CO (16vs.31, p<0.001), and AB (12vs.25, p<0.001). A significant worsening of sexual and urinary function was observed for IONB patients in the long-term follow-up. At matched pair analysis, Global health status(GQoL) was similar between the two groups (65vs.62, p=0.385). Significant better scores were observed in the IONB group for the following items: CF (p=0.007), FA (p=0.003), pain(PA) (p=0.019), DY (p=0.016), CO (p=0.001), AB (p=0.00).

IONB and IC after RC didn't show significant difference in terms of GQoL. IONB provides better results in some aspects of HR-QoL mainly related to bowel function as compared with IC but a worsening of urinary and sexual functions. Further RCTs are needed to confirm these data.

Urology. 2017 Jun 23 [Epub ahead of print]

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 Verze, Walter Artibani

University of Verona, Urology Clinic, Department of Surgery Dentistry Paediatrics and Gynaecology, Verona Italy., Department of Urology, Bolzano General Hospital, Bolzano., Urology Department, University of Florence, Careggi Hospital, Italy. Electronic address: ., Urology Department, University of Florence, Careggi Hospital, Italy., University of Verona, TESIS Department, Verona, Italy., University of Padua, Urology Department, Padua, Italy., Catholic University Policlinico Gemelli, Urology Department, Rome, Italy., University of Naples, Urology Department, Naples, Italy., IRCCS-CRO, Unit of Epidemiology and Biostatistics, Aviano, Italy., Trieste University, Urology Department, Trieste, Italy.