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Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladder cancer: a multicentre observational study

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Abstract

Purpose

Ileal orthotopic neobladder (IONB) reconstruction is the preferred urinary diversion among selected patients who have undergone radical cystectomy (RC) for bladder cancer (BCa). There is insufficient data regarding patients’ quality of life (QoL), sexual and urinary outcomes. Our objectives were to assess QoL in a multicentre cohort study, and to identify related clinical, oncological and functional factors.

Methods

Patients who underwent RC with IONB reconstruction for BCa from 2010 to 2017 at one of the three French hospitals completed the following self-reported questionnaires: European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Univariate and multivariate analyses were computed to identify clinical, pathological, and functional predictors of global QoL score.

Results

Seventy-three patients completed questionnaires. The median age was 64 years and 86.3% were men. The median interval between surgery and responses to questionnaires was 36 months (range 12–96). Fifty-five percent of patients presented a high global QoL (EORTC-QLQC30, median score 75). A pre-RC American Society of Anesthesiologists score > 2, active neoplasia, sexual inactivity, and stress urinary incontinence were associated with a worse QoL. After a multivariate analysis, sexual inactivity was the only independent factor related to an altered QoL.

Conclusion

Patients with IONB reconstruction after RC have a high global QoL. Sexual activity could independently impact the global QoL, and it should be assessed pre- and post-operatively by urologists.

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Availability of data and material

The data that support the findings of this study are available from the corresponding author (VT) upon reasonable request.

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Author notes

  1. E. Pons-Tostivint and M. Roumiguié have equally contributed to this work.

Authors and Affiliations

  1. Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400, Toulouse, France

    V. Tostivint, J. Gas, J. Zgheib, M. Thoulouzan, M. Soulié, X. Gamé, J. B. Beauval & M. Roumiguié

  2. Department of Urology, University Hospital, Rennes, France

    G. Verhoest

  3. Department of Biostatistics, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Toulouse, France

    B. Cabarrou

  4. Department of Urology, René Dubos Hospital, Pontoise, France

    J. Gas & P. Coloby

  5. Medical Oncology Department, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Toulouse, France

    E. Pons-Tostivint

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  1. V. Tostivint
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Contributions

VT: Protocol/project development, Data collection, Manuscript writing. BC: Data analysis. GV, JG, PC, JZ, MT, MS, XG: Data collection. JBB: Protocol/project development, Manuscript writing. EPT: Manuscript writing. MR: Protocol/project development.

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Correspondence to V. Tostivint.

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Tostivint, V., Verhoest, G., Cabarrou, B. et al. Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladder cancer: a multicentre observational study. World J Urol 39, 2525–2530 (2021). https://doi.org/10.1007/s00345-020-03484-6

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  • DOI: https://doi.org/10.1007/s00345-020-03484-6

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