No Decline in Health-Related Quality of Life After Radical Cystectomy

By Reuters Staff

October 25, 2021

NEW YORK (Reuters Health) - Radical cystectomy (RC) with urinary diversion does not appear to lead to a decline in health-related quality of life (HRQOL), according to a new study.

RC with urinary diversion is the gold-standard therapy for high-risk bladder cancer but has the potential for profound changes to HRQOL, Dr. Matthew Clements and colleagues from Memorial Sloan Kettering Cancer Center in New York note in a paper in European Urology.

To investigate, 411 patients who underwent RC, including 205 with ileal conduit and 206 with continent diversion. They collected 14 patient-reported outcomes before surgery and up to two years after surgery.

While there were decreases in some domains capturing physical health up to six months after RC, by 24 months, HRQOL "returned to or exceeded baseline in all domains other than sexual function," the researchers report.

For psychosocial domains, scores remained stable or improved over time, although patients receiving ileal conduit diversions showed decreases in body image.

"Importantly, at three months postoperatively, no large effects on domains related to daily functioning - deemed important by patients in qualitative assessments - were reported by most patients," the study team reports.

A limitation of the study is that the results are based on a single center doing a high volume of RC procedures.

Despite that, the researchers say these "contemporary outcomes and the excellent locoregional control provided by RC further support it as the gold standard therapy for high-risk bladder cancer."

"These data should be incorporated into preoperative RC counseling to lessen the uncertainty associated with life after surgery," they add.

SOURCE: European Urology, online October 8, 2021.