Prospective comparative study of quality of life in patients with bladder cancer undergoing cystectomy with ileal conduit or bladder preservation.

Abstract

Objective: To compare health-related quality of life (HRQOL) in patients undergoing radical cystectomy with ileal conduit (RC) or bladder preservation (BP) with (chemo)radiotherapy for bladder cancer.

Methods and analysis: Patients with bladder cancer, stage cT1-T4, cN0-N1, M0 with a minimum follow-up of 6 months from curative treatment (RC or BP) and without disease were eligible for inclusion. Two HRQOL instruments were administered: Bladder Cancer Index (BCI) for bladder cancer-specific HRQOL and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The mean QOL scores across various domains and specific questions were compared between the two treatment groups using an independent t-test.

Results: Out of the 104 enrolled patients, 56 underwent RC and 48 opted for BP, with 95 (91.3%) being male. The median time from treatment completion to QOL assessment was 22 months (IQR 10-56). The median age for the entire cohort was 62 years (IQR 55-68), 65.5 years (IQR 55-71) in BP and 59.5 years (IQR 55-66) in RC. There was no significant difference in mean BCI urinary and bowel scores in function or bother subdomains between the two groups. Overall, BCI sexual scores were low in both groups but significantly better after BP (BPmean 56.9, RCmean 41.5, p=0.01). Mean scores for sexual function subdomain were BPmean 38.4 and RCmean 25 (p=0.07) and for sexual bother were BPmean 81 RCmean 62 (p=0.02). The EORTC QLQ-C30 outcomes did not show a significant difference in either group.

Conclusion: The BP group showed significantly better results in the sexual domain compared with the RC group. Both groups had good QOL in terms of urinary and bowel functions.