A prospective evaluation of quality of life, psychosocial distress, and functional outcomes two years after radical cystectomy and urinary diversion in 842 German bladder cancer patients.

IF 3.1 2区 医学 Q2 ONCOLOGY
Journal of Cancer Survivorship Pub Date : 2025-06-01 Epub Date: 2024-01-30 DOI:10.1007/s11764-024-01535-0
Henning Bahlburg, Alina Reicherz, Moritz Reike, Peter Bach, Marius Cristian Butea-Bocu, Karl Heinrich Tully, Florian Roghmann, Joachim Noldus, Guido Müller
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Abstract

Purpose: This study aims to evaluate survival, health-related quality of life (HRQoL), psychosocial distress, and functional outcomes after radical cystectomy (RC) and urinary diversion for ileal neobladder (INB) or ileal conduit (IC) in a contemporary German cohort of bladder cancer patients.

Methods: Patients undergoing inpatient rehabilitation after RC between April 2018 and December 2019 in one high-volume rehabilitation center were surveyed regarding HRQoL, psychosocial distress, and functional outcomes until two years after RC.

Results: Eight-hundred forty-two patients (683 male, 159 female; 395 INB, 447 IC) were included. Patients with an IC suffered more often from locally advanced disease (≥ pT3; 41.4% vs. 24.1%, p < 0.001) and lymph node metastases (19.9% vs. 11.8%, p = 0.002), resulting in worse probability of survival (p < 0.001). Global HRQoL improved steadily during follow-up, but significant differences in subscales persisted between cohorts. Multivariable regression analysis identified IC, male sex, and patient age ≤ 59 years as independent predictors for persistent high psychosocial distress. Almost 42% of female patients reported severe urinary incontinence two years after RC. Most men reported severely diminished erectile function, even after nerve-sparing surgery.

Conclusion: Global HRQoL two years after RC is comparable to the general German population. Female patients should be informed about worse continence rates. Conversely, men should be educated about erectile dysfunction. Aftercare should include psycho-oncologic counseling, especially for patients at risk.

Implications for cancer survivors: Patients should be counseled on long-term functional outcomes and persistent psychosocial distress after RC. Closer cooperation between urologists and psycho-oncologists is needed.

Abstract Image

对 842 名德国膀胱癌患者进行根治性膀胱切除术和尿路改道术后两年的生活质量、社会心理压力和功能效果进行前瞻性评估。
目的:本研究旨在评估当代德国膀胱癌患者队列中根治性膀胱切除术(RC)和回肠新膀胱(INB)或回肠导尿管(IC)尿路转流术后的生存率、健康相关生活质量(HRQoL)、社会心理困扰和功能预后:2018年4月至2019年12月期间,在一家高容量康复中心接受RC术后住院康复治疗的患者接受了关于RC术后两年前的HRQoL、心理社会困扰和功能结果的调查:共纳入 842 名患者(683 名男性,159 名女性;395 名 INB,447 名 IC)。IC患者更多罹患局部晚期疾病(≥ pT3; 41.4% vs. 24.1%,p 结论:IC患者在RC术后两年内的总体HRQoL为≥ pT3:RC 术后两年的总体 HRQoL 与德国普通人群相当。女性患者应了解较差的失禁率。相反,男性则应了解勃起功能障碍。术后护理应包括肿瘤心理咨询,尤其是针对高危患者:对癌症幸存者的启示:应就 RC 后的长期功能结果和持续的心理社会困扰为患者提供咨询。泌尿科医生和肿瘤心理医生之间需要更紧密的合作。
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来源期刊
CiteScore
7.00
自引率
10.80%
发文量
149
审稿时长
>12 weeks
期刊介绍: Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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