Prospective evaluation of health-related quality of life after radical cystectomy: focus on peri- and postoperative complications

Kretschmer, Alexander; Grimm, Tobias; Büchner, Alexander; Grabbert, Markus; Jokisch, Friedrich; Schneevoigt, Birte-Swantje; Apfelbeck, Maria; Schulz, Gerald Bastian; Stief, Christian G.; Karl, Alexander

doi:10.1007/s00345-016-1992-2

Cited by 22 publications

(11 citation statements)

References 23 publications

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“…These authors have shown that NB women with NI presented significant lower scores than IC women in all EORTC-QLQ-C30 domains. Moreover, higher ICIQ-SF scores were independent predictors for decreased global health scores (QLQ-C30) (14). This strong association between continence and QoL reinforces the importance of nerve-sparing during RC.…”

Section: Discussionmentioning

confidence: 56%

“…However, when comparing only continent NB vs. IC, better results in global health, physical, cognitive, and emotional functioning were found in NB. Also using QLQ-C30, Kretschmer et al (14) found higher global health status as well as physical and role functioning in NB patients at three months and preoperatively. While, at 12 months, only the physical score remained higher, and the global score differences disappeared, even though a significant decrease in physical functioning occurred in both groups at 3 th and 12th postoperative months when comparing to baseline scores.…”

Section: Studies Showing Similar Resultsmentioning

confidence: 99%

“…Thus, at 18 months, the scores were even higher than baseline levels. Differently, using the same questionnaire, Kretschmer et al described a significant worsening in physical and role function after 6 and 12 months (14).…”

Section: Discussionmentioning

confidence: 97%

“…Finally, it is essential to highlight that some studies applied the EORTC-QLQ-C30 questionnaire alone (9,14). Although this is a validated tool for HRQOL assessment, it does not include specific questions about urinary function and incontinence.…”

Section: Discussionmentioning

confidence: 99%

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HRQOL related to urinary diversion in Radical Cystectomy: a systematic review of recent literature

et al. 2019

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Introduction: The health-related QoL is a patient-centered evaluation covering several aspects. This evaluation seems to be particularly important in patients submitted to radical cystectomy (RC) and urinary diversion with ileal conduit (IC) or a neobladder (NB). Objective: Review all recent data comparing QoL outcomes after radical cystectomy with NB and IC diversions. Evidence Acquisition: A systematic search in PubMed/Medline, Embase, and Cochrane databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement in December 2018. All articles published from January 01, 2012 to December 31, 2018, were included. A study was considered relevant if it compared QoL outcomes using validated questionnaires (EORTC QLQ C30, FACT-G, FACT-BL, FACT-VCI, and BCI). Evidence Synthesis: In 11 included studies, a total of 1389 participants were accounted (730 NB and 659 IC cases). The studies were conducted in 8 different countries, two were prospective, and none was randomized. There were two studies favoring results with a neobladder, 3 with incontinent diversion and 6 with no differences. The EORTC-QLQ-C30 was the most used instrument (5 studies) followed by FACT VCI and BCI (3 studies each). Given the heterogeneity of data and lack of prospective studies, a meta-analysis was not performed. Conclusion: No superiority of one urinary diversion was characterized. It seems that the choice must be individualized with an extensive preoperative orientation of the patient and their relatives. That will probably infl uence how the patient accepts the new condition.

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Section: Discussionmentioning

confidence: 56%

Section: Studies Showing Similar Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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HRQOL related to urinary diversion in Radical Cystectomy: a systematic review of recent literature

et al. 2019

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“…The rates of perioperative mortality and morbidity following surgery remain of great concern. The occurrence of a perioperative complication has been shown to reduce patients' quality of life, [1][2][3] longevity, [4,5] and substantially increase costs. [6,7] Therefore, providing accurate pre-surgical risk assessment to patients is essential to support an informed decision regarding surgery [8][9][10] and increases the burden on surgeons to provide more complete and interpretable information about any operation.…”

Section: Introductionmentioning

confidence: 99%

The value of the "Surgical Risk Preoperative Assessment System" (SURPAS) in preoperative consultation for elective surgery: a pilot study.

Bronsert

Lambert-Kerzner

Henderson

et al. 2020

Preprint

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Background: Risk assessment is essential to informed decision making in surgery. Preoperative use of the Surgical Risk Preoperative Assessment System (SURPAS) providing individualized risk assessment, may enhance informed consent. We assessed patient and provider perceptions of SURPAS as a risk assessment tool.Methods: A convergent mixed-methods study assessed SURPAS’s trial implementation, concurrently collecting quantitative and qualitative data, separately analyzing it, and integrating the results. Patients and providers were surveyed and interviewed on their opinion of how SURPAS impacted the preoperative encounter. Relationships between patient risk and patient and provider assessment of SURPAS were examined.Results: A total of 197 patients were provided their SURPAS postoperative risk estimates in nine surgeon’s clinics. Of the total patients, 98.8% reported they understood their surgical risks very or quite well after exposure to SURPAS; 92.7% reported SURPAS was very helpful or helpful. Providers shared that 83.4% of the time they reported SURPAS was very or somewhat helpful; 44.7% of the time the providers reported it changed their interaction with the patient and this change was beneficial 94.3% of the time. As patient risk increased, providers reported that SURPAS was increasingly helpful (p<0.0001).Conclusions: Patients and providers reported the use of SURPAS helpful and informative during the preoperative risk assessment of patients, thus improving the surgical decision making process. Patients thought that SURPAS was helpful regardless of their risk level, whereas providers thought that SURPAS was more helpful in higher risk patients.

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Salvage cystectomy and ileal conduit urinary diversion as a last‐line option for benign diseases—perioperative safety and postoperative health‐related quality of life

Volz

Eismann

Pfitzinger

et al. 2021

Neurourology and Urodynamics

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Aims Radical cystectomy and urinary diversion impact various dimensions of patients' health‐related‐quality‐of‐life (HRQOL). Yet, less is known about salvage cystectomy as a last‐line option for treatment‐refractory benign diseases. Therefore, our aim is to provide HRQOL data from a contemporary cohort of open salvage cystectomies for benign conditions. Methods Fifty‐four consecutive patients were enrolled in one single tertiary referral center. Analysis was limited to patients undergoing urinary diversion via ileal conduit (IC). Complications were assessed via Clavien–Dindo‐scale. HRQOL was measured using the validated European Organization for Research and Treatment of Cancer QLQ‐C30 and QLQ‐BLM30 questionnaire. HRQOL QLQ‐C30 domains were measured preoperatively and up to 3 years postoperatively. Longitudinal changes were analyzed using Friedman's rank test. Primary endpoint was good general HRQOL based on QLQ‐C30 global health status (GHS). Multivariate analysis was performed using logistic regression models with a step‐wise backward selection procedure. Results Longitudinal analysis of HRQOL subdomains revealed significantly improved pain (p = .005) and fatigue (p = .002) scores as well as improved social functioning (p = .038). Furthermore, general HRQOL (GHS scores) improved significantly during the follow‐up period (28.0 vs. 50.6 [36 months], p = .045). In multivariate analysis, the indication for salvage cystectomy could not be identified as an independent predictor for good general HRQOL. We observed a total number of 10 (41.7%) high‐grade (Clavien ≥III) 90 day‐complications. Limitations include limited follow‐up rates at respective time‐points. Conclusion Salvage cystectomy and IC can be safely performed as a last‐line treatment for benign conditions and increases general HRQOL in the long‐term follow‐up. Thus, it can play a role in a holistic approach for a challenging clinical setting.

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Prospective evaluation of health-related quality of life after radical cystectomy: focus on peri- and postoperative complications

Cited by 22 publications

References 23 publications

HRQOL related to urinary diversion in Radical Cystectomy: a systematic review of recent literature

HRQOL related to urinary diversion in Radical Cystectomy: a systematic review of recent literature

The value of the "Surgical Risk Preoperative Assessment System" (SURPAS) in preoperative consultation for elective surgery: a pilot study.

Salvage cystectomy and ileal conduit urinary diversion as a last‐line option for benign diseases—perioperative safety and postoperative health‐related quality of life

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