Variables affecting quality of life after Radical cystectomy and neobladder substitution: Egyptian National Cancer Institute experience.

Autor:	El Azab A; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: dr_abdallaazab@hotmail.com., Hossam E; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: Dr.eslam.hossam@gmail.com., Abdelrahman I; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: Ibrahim.abdelrahman@nci.cu.edu.eg., Aboulkassem H; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: hatem.aboulkassem@nci.cu.edu.eg., Fadlalla WM; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: wfadlalla@gmail.com., Abdelbary A; Department of Surgical Oncology, Cairo University, National Cancer Institute, Cairo, Egypt. Electronic address: ahmed.abdelbary@nci.cu.edu.eg.
Jazyk:	angličtina
Zdroj:	Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie [Prog Urol] 2022 May; Vol. 32 (6), pp. 410-418. Date of Electronic Publication: 2021 Jul 24.
DOI:	10.1016/j.purol.2021.07.002
Abstrakt:	Introduction: To evaluate the functional outcomes and quality of life beyond 1 year, in patients treated with radical cystectomy and orthotopic diversion for invasive bladder cancer. To investigate various potential contributing factors on patient's quality of life after radical cystectomy and urinary diversion via orthotopic neobladder. Materials and Methods: This retrospective study was conducted at the National Cancer Institute (NCI), Cairo; including a total of 97 patients who underwent radical cystectomy and orthotopic diversion. Functional and sexual outcome and patient QoL were assessed by ICIQ-SF, IIEF-5 and QLQ-C30 questionnaires. Potential association of patient QoL with pre-and intraoperative variables was studied. Results: Our results show that preoperative ECOG performance status 0 (P=0.0001), and nerve sparing surgery (P=0.001), were associated with high QoL and functional outcomes. On the contrary, ECOG performance status 2, preoperative comorbidities as ischemic heart diseases (P=0.01), recurrence (0.041), adjuvant chemotherapy (P=0.017) and radiotherapy (P=0.001) were associated with low QoL on univariate analysis. However, only ECOG performance status 2 (P<0.0001), incontinence (P<0.0001), non-nerve sparing surgery (P=0.001) and ureteric stricture (P=0.001) were independent predictors of worse QoL on multivariate analysis. Conclusion: Orthotopic bladder is associated with increased morbidity. Attention should be given to preoprative patient characteristics at the time of patient selection, and intraoperative quality of functional preservation. (Copyright © 2021. Published by Elsevier Masson SAS.)
Databáze:	MEDLINE
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