Derivación urinaria y calidad de vida: 6 años de seguimiento después de la cirugía para el cáncer de vejiga

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-04-01 DOI:10.1016/j.acuro.2025.501699

N. Pyrgidis , J. Hermans , P. Keller, D. Karatas, B. Ebner, G. Schulz, C. Stief, Y. Volz

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引用次数: 0

Abstract

Objectives

To evaluate health-related quality of life (HRQOL) six years post-radical cystectomy in patients with muscle-invasive bladder cancer, comparing orthotopic ileal neobladder (ONB) and ileal conduit (IC). Therefore, the study aims to analyze the under-investigated long-term impact of standard bladder cancer treatments on HRQOL and provide insights into the HRQOL differences associated with these two common urinary diversion methods.

Patients and methods

This prospective study included 39 patients with urothelial carcinoma treated with ONB or IC at our center between 03/2013 and 01/2023. Patients with variant histology, metastasis, neoadjuvant chemotherapy, or benign indications for cystectomy were excluded. HRQOL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire preoperatively, at four and six years postoperatively. Statistical analyses included Chi-square tests, T-tests, and logistic regression models.

Results

Of the patients, 64% (25/39) underwent ONB, and 76.9% (30/39) were male, with an average age of 69 years. No significant differences in overall good HRQOL (GHS >70) were observed between ONB and IC at six years (IC: 60 ± 22; ONB: 69 ± 23, p = 0.2). Patients with IC reported higher insomnia at both follow-ups (4 years: p = 0.01; 6 years: p = 0.03). Emotional function remained stable in ONB patients but declined in IC patients from the fourth to sixth years (p = 0.04).

Conclusions

Long-term HRQOL did not significantly differ between ONB and IC up to six years post-radical cystectomy. Both urinary diversion methods can be offered to patients, with tailored discussions in terms of HRQOL.

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尿路导流与生活质量：膀胱癌术后6年随访

目的比较原位回肠新膀胱（ONB）和回肠导管（IC）在肌肉浸润性膀胱癌根治性膀胱切除术后6年的健康相关生活质量（HRQOL）。因此，本研究旨在分析标准膀胱癌治疗对HRQOL的长期影响，并深入了解两种常见的尿分流方法对HRQOL的影响。患者和方法本前瞻性研究纳入2013年3月至2023年1月在本中心接受ONB或IC治疗的39例尿路上皮癌患者。排除组织学变化、转移、新辅助化疗或良性指征的患者。术前、术后4年和6年采用欧洲癌症研究与治疗组织（EORTC） QLQ-C30问卷对HRQOL进行评估。统计分析包括卡方检验、t检验和逻辑回归模型。结果接受ONB的患者占64%(25/39)，其中男性占76.9%(30/39)，平均年龄69岁。6年时，ONB组和IC组的总体良好HRQOL （GHS >70）无显著差异(IC: 60±22；ONB: 69±23,p = 0.2)。在两次随访中，IC患者的失眠率均较高(4年：p = 0.01；6年：p = 0.03)。ONB患者的情绪功能保持稳定，而IC患者的情绪功能从第4年到第6年下降（p = 0.04）。结论在根治性膀胱切除术后6年，ONB和IC的长期HRQOL无显著差异。两种尿转移方法都可以提供给患者，并根据HRQOL进行量身定制的讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.