Prognostic features for quality of life after radical cystectomy and orthotopic neobladder
Int. braz. j. urol
;
42(6): 1109-1120, Nov.-Dec. 2016. tab, graf
Article
in English
| LILACS
| ID: biblio-828927
ABSTRACT
ABSTRACT Purpose:
To analyse prognostic features on quality of life (QoL) following radical cystectomy and urinary diversion via orthotopic neobladder in a single-centre patient cohort. Materials andMethods:
Postoperative QoL of 152 patients was assessed retrospectively using the validated QLQ-C30 questionnaire. Potential associations of patient's quality of life including pre-and intraoperative characteristics, surgeon experience, postoperative time course, adjuvant therapies, and functional outcome were defined a priori and evaluated. Mann-Whitney-U-, Kruskal-Wallis-, Spearman correlation and post hoc-testing were used. A multivariate analysis using a multiple logistic regression model was performed. A p value <0.05 was considered to be statistically significant.Results:
Median follow-up was 48 months. Univariate analysis of prognostic features for health-related QoL revealed a significant impact of gender (p=0.019), performance status (p<0.001), experience of surgeon (>100 previous cystectomies, p=0.007), and nerve-sparing surgery (p=0.001). Patients who underwent secondary chemotherapy or radiotherapy had significant lower QLQ-C30 scores (p=0.04, p=0.02 respectively). Patients who were asymptomatic had a significantly higher quality of life (p<0.001). A significant impact of severity of incontinence based on ICIQ-SF score (p<0.001) and daily pad usage (p<0.001), existence of daytime incontinence (p<0.001), existence of urgency symptoms (p=0.007), and IIEF-5 score (p<0.001) could be observed. In multivariate analysis, independent prognostic relevance could be confirmed for preoperative ECOG performance status of 0 (p=0.020 vs. ECOG 1, p=0.047 vs. ECOG 2), experience of the respective surgeon (≥100 vs. <100 previous cystectomies, p=0.021), and daytime continence (p=0.032).Conclusion:
In the present study, we report health-related QoL outcomes in a contemporary patient cohort and confirm preoperative ECOG status, surgeon experience and daytime incontinence as independent prognostic features for a good postoperative QoL.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Quality of Life
/
Urinary Diversion
/
Urinary Bladder Neoplasms
/
Cystectomy
/
Health Status
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2016
Type:
Article
Affiliation country:
Germany
Institution/Affiliation country:
Ludwig - Maximilians - University/DE
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