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Open Access 01-12-2013 | Research

Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors

Authors: Mauro Gacci, Omar Saleh, Tommaso Cai, John L Gore, Carolina D’Elia, Andrea Minervini, Lorenzo Masieri, Claudia Giannessi, Michele Lanciotti, Virginia Varca, Alchiede Simonato, Sergio Serni, Giorgio Carmignani, Marco Carini

Published in: Health and Quality of Life Outcomes | Issue 1/2013

Abstract

Purpose

Women undergoing radical cystectomy (RC) and urinary diversion for bladder cancer experience substantial limitations in health-related quality of life (HRQOL). However, the level of discomfort caused by different urinary diversion has been never evaluated in long term survivors. The aim of this multicenter study is to evaluate differences in HRQOL among recurrence-free women undergoing cutaneous ureterostomy (CUS), Bricker's ileal conduit (BK-IC) and Orthotopic neobladder VIP (ONB-VIP) in disease-free females treated with radical cystectomy (RC), with long-term follow up (mean 60.1 months; range 36-122 months).

Materials and methods

All consecutively treated female patients from two urological institutions who underwent RC and urinary diversion from January 2000 to December 2008, with no evidence of tumor recurrence at a minimum follow up of 36 months, were included. Patients received the European Organisation for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the Functional Assessment of Cancer Therapy for Bladder Cancer (FACT-BL). Clinical data and questionnaire results were analyzed in order to evaluate the HRQOL differences among diversion groups.

Results

We identified 37 females (median age: 68, range 45–82 years), including 12 status-post CUS, 16 who underwent BK-IC, and 9 who underwent ONB-VIP. Most were healthy (24/37 with no comorbidities, 4/37 Charlson 1-2, 9/37 Charlson 3 or greater – we didn’t considered bladder cancer in Charlson evaluation because bladder cancer was the main inclusion criteria). Women undergoing CUS endorsed worse FACT-BL scores compared with BK-IC and ONB-VIP patients, worse HRQOL regarding physical and emotional well-being (p=0.008 and p=0.02, respectively), and a trend toward worse EORTC QLQ-C30 scores for appetite loss and fatigue (p=0.05 for both).

Conclusions

In our study long-term disease-free females treated with CUS endorsed worse HRQOL compared with women who underwent BK-IC or ONB-VIP, mostly due to worse physical and emotional perception of their body image.

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Title: Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors
Authors: Mauro Gacci
Omar Saleh
Tommaso Cai
John L Gore
Carolina D’Elia
Andrea Minervini
Lorenzo Masieri
Claudia Giannessi
Michele Lanciotti
Virginia Varca
Alchiede Simonato
Sergio Serni
Giorgio Carmignani
Marco Carini
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-11-43

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Quality of life in women undergoing urinary diversion for bladder cancer: results of a multicenter study among long-term disease-free survivors

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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