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Park J, Choi YD, Lee K, Seo M, Cho A, Lee S, Nam KH. Quality of life patterns and its association with predictors among non-muscle invasive bladder cancer survivors: A latent profile analysis. Asia Pac J Oncol Nurs 2022; 9:100063. [PMID: 35665310 PMCID: PMC9157190 DOI: 10.1016/j.apjon.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study identified group patterns in the quality of life (QOL), as well as examining factors associated with group membership, among non-muscle invasive bladder cancer (NMIBC) survivors. Methods This was a cross-sectional study involving 278 participating NMIBC survivors. Mplus version 7.2 was used to perform the latent profile analysis of QOL using the EORTC QLQ-NMIBC-24. The participants’ social support, self-efficacy, knowledge level, depression, perceived severity of and susceptibility of cancer recurrence, and their demographic and clinical characteristics were compared between the subgroups, with a logistic regression analysis being adopted to examine the factors associated with the QOL subgroups. Results The NMIBC survivors based on the QOL were classified into two subgroups: “QOL-high” (81.3%) and “QOL-low” (18.7%). Having ≥ 3 disease recurrences, perceived susceptibility toward and severity of cancer recurrence, and having depressive symptoms were significantly associated with the “QOL-low” group. Conclusions Participants with frequent recurrences of NMIBC, higher perceived susceptibility and severity levels, and depressive symptoms had lower QOL. Therefore, it is necessary to develop intervention programs targeting participants with these characteristics to improve their QOL.
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Affiliation(s)
- Jeongok Park
- College of Nursing and Mo-Im Kim Nursing Research Institute, Faculty of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Young Deuk Choi
- College of Medicine, Faculty of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Kyoungjin Lee
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea and College of Nursing, Faculty of Nursing, Kyungbok University, Namyangju, Republic of Korea
| | - Miae Seo
- College of Nursing and Mo-Im Kim Nursing Research Institute, Research Assistant, Yonsei University, Seoul, South Korea and Division of Nursing, Registered Nurse, Severance Hospital, Seoul, Republic of Korea
| | - Ahyoung Cho
- College of Nursing and Mo-Im Kim Nursing Research Institute, Research Assistant, Yonsei University, Seoul, Republic of Korea
| | - Sejeong Lee
- College of Nursing and Brain Korea 21 FOUR Project, Graduate Student, Yonsei University, Seoul, Republic of Korea
| | - Keum-hee Nam
- College of Nursing, Faculty of Nursing, Kosin University, Busan, Republic of Korea
- Corresponding author.
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Kimura T, Ishikawa H, Kojima T, Kandori S, Kawahara T, Sekino Y, Sakurai H, Nishiyama H. Bladder preservation therapy for muscle invasive bladder cancer: the past, present and future. Jpn J Clin Oncol 2020; 50:1097-1107. [PMID: 32895714 DOI: 10.1093/jjco/hyaa155] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022] Open
Abstract
Radical cystectomy is the gold standard treatment for muscle invasive bladder cancer, but some patients have medically inoperable disease or refuse cystectomy to preserve their bladder function. Bladder preservation therapy with transurethral resection of the bladder tumor and concurrent chemoradiotherapy, known as trimodal treatment, is regarded to be a curative-intent alternative to radical cystectomy for patients with muscle invasive bladder cancer during the past decade. After the development of immune checkpoint inhibitors, a world-changing breakthrough occurred in the field of metastatic urothelial carcinoma and many clinical trials have been conducted against non-muscle invasive bladder cancer. Interestingly, preclinical and clinical studies against other malignancies have shown that immune checkpoint inhibitors interact with the radiation-induced immune reaction. As half of the patients with muscle invasive bladder cancer are elderly, and some have renal dysfunction, not only as comorbidity but also because of hydronephrosis caused by their tumors, immune checkpoint inhibitors are expected to become part of a new therapeutic approach for combination treatment with radiotherapy. Accordingly, clinical trials testing immune checkpoint inhibitors have been initiated to preserve bladder for muscle invasive bladder cancer patients using radiation and immune checkpoint inhibitors with/without chemotherapy. The objective of this review is to summarize the evidence of trimodal therapy for muscle invasive bladder cancer during the past decade and to discuss the future directions of bladder preservation therapy in immuno-oncology era.
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Affiliation(s)
- Tomokazu Kimura
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hitoshi Ishikawa
- Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takahiro Kojima
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shuya Kandori
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takashi Kawahara
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuta Sekino
- Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Rammant E, Van Wilder L, Van Hemelrijck M, Pauwels NS, Decaestecker K, Van Praet C, Bultijnck R, Ost P, Van Vaerenbergh T, Verhaeghe S, Van Hecke A, Fonteyne V. Health-related quality of life overview after different curative treatment options in muscle-invasive bladder cancer: an umbrella review. Qual Life Res 2020; 29:2887-2910. [PMID: 32504291 DOI: 10.1007/s11136-020-02544-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE This umbrella review aims to evaluate the quality, summarize and compare the conclusions of systematic reviews investigating the impact of curative treatment options on health-related quality of life (HRQoL) in muscle-invasive bladder cancer (MIBC). METHODS The Cochrane Library, MEDLINE, Embase and Web of Science were searched independently by two authors from inception until 06 January 2020. Systematic reviews and meta-analyses assessing the impact of any curative treatment option on HRQol in MIBC patients were eligible. Risk of bias was assessed using the AMSTAR 2 tool. RESULTS Thirty-two reviews were included. Robot-assisted RC with extracorporeal urinary diversion and open RC have similar HRQoL (n = 10). Evidence for pelvic organ-sparing RC was too limited (n = 2). Patients with a neobladder showed better overall and physical HRQoL outcomes, but worse urinary function in comparison with ileal conduit (n = 17). Bladder-preserving radiochemotherapy showed slightly better urinary and sexual but worse gastro-intestinal HRQoL outcomes in comparison with RC patients (n = 6). Quality of the reviews was low in more than 50% of the available reviews and most of the studies included in the reviews were nonrandomized studies. CONCLUSION This umbrella review gives a comprehensive overview of the available evidence to date.
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Affiliation(s)
- Elke Rammant
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Lisa Van Wilder
- Department of Public Health and Primary Care, University Hospital, Ghent University, Ghent, Belgium
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Nele S Pauwels
- The Knowledge Center for Health Ghent, Ghent University, Ghent, Belgium
| | | | | | - Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Thomas Van Vaerenbergh
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, VIVES University College, Roeselare, Belgium.,Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
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Normann CO, Opheim R, Andreassen BK, Bernklev T, Haug ES. Health-related quality-of-life after radical cystectomy among Norwegian men and women compared to the general population. Scand J Urol 2020; 54:181-187. [DOI: 10.1080/21681805.2020.1754906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - Randi Opheim
- Faculty of Health and Society, University of Oslo, Oslo, Norway
| | | | - Tomm Bernklev
- Department of Research and Innovation, Vestfold Hospital Trust, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik S. Haug
- Department of Urology, Vestfold Hospital Trust, Oslo, Norway
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Yu EY, Nekeman D, Billingham LJ, James ND, Cheng KK, Bryan RT, Wesselius A, Zeegers MP. Health-related quality of life around the time of diagnosis in patients with bladder cancer. BJU Int 2019; 124:984-991. [PMID: 31077532 PMCID: PMC6907410 DOI: 10.1111/bju.14804] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To quantify the health-related quality of life (HRQoL) of patients with bladder cancer around the time of diagnosis and to test the hypotheses of a two-factor model for the HRQoL questionnaire QLQ-C30. METHODS From participants in the Bladder Cancer Prognoses Programme, a multicentre cohort study, sociodemographic data were collected using semi-structured face-to-face interviews. Answers to the QLQ-C30 were transformed into a scale from 0 to 100. HRQoL data were analysed in multivariate analyses. The hypothesized two-factor (Physical and Mental Health) domain structure of the QLQ-C30 was also tested with confirmatory factor analyses (CFA). RESULTS A total of 1160 participants (78%) completed the questionnaire after initial visual diagnosis and before pathological confirmation. Despite non-muscle-invasive bladder cancer (NMIBC) being associated with a higher HRQoL than carcinoma invading bladder muscle, only the domain Role Functioning was clinically significantly better in patients with NMIBC. Age, gender, bladder cancer stage and comorbidity all had a significant influence on QLQ-C30 scores. The CFA showed an overall good fit of the hypothesized two-factor model. CONCLUSION This study identified a baseline reference value for HRQoL for patients with bladder cancer, which allows better evaluation of any changes in HRQoL as disease progresses or after treatment. In addition, a two-factor (Physical and Mental Health) model was developed for the QLQ-C30.
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Affiliation(s)
- Evan Yi‐Wen Yu
- NUTRIM School for Nutrition and Translational Research in MetabolismUniversity of MaastrichtMaastrichtthe Netherlands
- CAPHRI School for Public Health and Primary CareUniversity of MaastrichtMaastrichtthe Netherlands
| | - Duncan Nekeman
- Department of Public Health, Epidemiology and BiostatisticsSchool of Health and Population SciencesUniversity of BirminghamBirminghamUK
| | - Lucinda J. Billingham
- MRC Midland Hub for Trials Methodology Research and Cancer Research UK Clinical Trials UnitUniversity of BirminghamBirminghamUK
| | | | - KK Cheng
- Department of Public Health, Epidemiology and BiostatisticsSchool of Health and Population SciencesUniversity of BirminghamBirminghamUK
| | | | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in MetabolismUniversity of MaastrichtMaastrichtthe Netherlands
| | - Maurice P. Zeegers
- CAPHRI School for Public Health and Primary CareUniversity of MaastrichtMaastrichtthe Netherlands
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Rangarajan K, Somani BK. Trends in quality of life reporting for radical cystectomy and urinary diversion over the last four decades: A systematic review of the literature. Arab J Urol 2019; 17:181-194. [PMID: 31489233 PMCID: PMC6711151 DOI: 10.1080/2090598x.2019.1600279] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2018] [Indexed: 11/12/2022] Open
Abstract
Objective: To report the trends in quality of life (QoL) reporting for radical cystectomy (RC) and urinary diversion (UD) over the last four decades, as RC for bladder cancer is associated with significant morbidity and QoL issues. Material and methods: We searched PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane library for published studies from January 1980 to January 2017 in the English language. We divided the published articles into three time periods: period-1 (1980-1997), period-2 (1998-2007) and period-3 (2008-2017). Results: A total of 85 QoL studies (8417 patients) were identified, of which 3347 (39.8%) patients had an ileal conduit (IC), 1078 (12.8%) had a continent UD (CD), 3264 (38.8%) had a neobladder (NB), and in the remaining 728 (8.6%) the type of UD was not specified. Whilst there were 15, 24 and 41 studies in period-1, period-2 and period-3 respectively, two (13%), 20 (83%) and 37 (90%) used a validated QoL tool; and none, six (25%) and 23 (56%) used a urology specific QoL tool during these three time periods. Similarly, the number of prospective studies increased from one (7%) to four (17%) and 14 (34%) in these three time periods. The proportion of reported IC patients reduced from 65% (784 patients) to 36% (899) and 35% (1664) from period-1 to period-3, whereas the proportion of NB patients increased from 4.5% (54) to 44% (1105) and 44% (2105). Over the last few years there have been QoL studies on laparoscopic and robotic IC and NB UDs. Conclusion: Our review suggests an increasing use of validated, bladder cancer-specific questionnaires with UD-specific constructs. Abbreviations: BCI: Bladder Cancer Index; BDI: Beck Depression Inventory; BIS: Body Image Scale; CD: continent urinary diversion; EORTC QLQ-30C: European Organisation for the Research and Treatment of Cancer Quality of Life 30-item core questionnaire; ERAS: enhanced recovery after surgery; FACT(-BL)(-G)(-VCI): Functional Assessment of Cancer Therapy(-Bladder Cancer)(-General)(-Vanderbilt Cystectomy Index); IC: ileal conduit; NB: neobladder; (HR)QoL: (health-related) quality of life; (RA)RC: (robot-assisted) radical cystectomy; SF-36: 36-item short-form health survey; SIP: Sickness Impact Profile; UD: urinary diversion.
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Health related quality of life after urinary diversion. Which technique is better? J Egypt Natl Canc Inst 2018; 30:93-97. [DOI: 10.1016/j.jnci.2018.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/29/2018] [Accepted: 08/05/2018] [Indexed: 11/18/2022] Open
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Perlis N, Krahn MD, Boehme KE, Alibhai SMH, Jamal M, Finelli A, Sridhar SS, Chung P, Gandhi R, Jones J, Tomlinson G, Bremner KE, Kulkarni G. The Bladder Utility Symptom Scale: A Novel Patient Reported Outcome Instrument for Bladder Cancer. J Urol 2018. [PMID: 29530786 DOI: 10.1016/j.juro.2018.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Health related quality of life is important in bladder cancer care and clinical decision making because patients must choose between diverse treatment modalities with unique morbidities. A patient reported outcome measure of overall health related quality of life for bladder cancer regardless of disease severity and treatment could benefit clinical care and research. MATERIALS AND METHODS Prospective questionnaire development was completed in 3 parts. In study 1 the BUSS (Bladder Utility Symptom Scale) questions were created by experts using a conceptual framework of bladder cancer health related quality of life generated through patient focus groups. In study 2 patients with bladder cancer, including those treated with surgery, radiation and chemotherapy, completed the BUSS and 5 health related quality of life instruments at baseline and 4 weeks to assess validity and test-retest reliability. External validity was then explored in study 3 by administering the BUSS to 578 patients online and at clinics. Construct validity was assessed by whole and subscale Spearman rank correlations, and by comparisons of BUSS scores across known groups. RESULTS The BUSS had high whole scale correlation with the FACT-Bl (Functional Assessment of Cancer Therapy-Bladder) (rs = 0.82, p <0.0001) and substantial to high subscale correlations with the EQ-5D™-3L (EuroQol 5 Dimensions Questionnaire-3 Levels) (eg emotional well-being rs = 0.69, p <0.0001). BUSS scores were lower in patients with comorbidity and advanced disease. Cognitive debriefing and the 94% completion rate suggested good comprehensibility. There was excellent test-retest reliability (ICC = 0.79). Limitations included an extended time from diagnosis in many patients. CONCLUSIONS The BUSS is a reliable and valid patient reported outcome instrument for health related quality of life in all patients with bladder cancer regardless of the treatment received or the stage of disease.
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Affiliation(s)
- Nathan Perlis
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada.
| | - Murray D Krahn
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Kirstin E Boehme
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Shabbir M H Alibhai
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Munir Jamal
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Srikala S Sridhar
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Peter Chung
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Rushi Gandhi
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Jennifer Jones
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - George Tomlinson
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Karen E Bremner
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
| | - Girish Kulkarni
- Division of Urology, Department of Surgery (NP, AF, RG, GK), University of Toronto and University Health Network, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative (MDK, KEBo, KEBr), University of Toronto and University Health Network, Toronto, Ontario, Canada; Division of Internal Medicine and Geriatrics (MDK, SMHA), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Medical Oncology (SSS), University of Toronto and University Health Network, Toronto, Ontario, Canada; Department of Radiation Oncology (PC), University of Toronto and University Health Network, Toronto, Ontario, Canada; University Health Network and Toronto General Research Institute (GT), Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Division of Urology, Trillium Health Partners (MJ), Mississauga, Ontario, Canada
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New F, Somani BK. A Complete World Literature Review of Quality of Life (QOL) in Patients with Kidney Stone Disease (KSD). Curr Urol Rep 2016; 17:88. [PMID: 27771854 PMCID: PMC5075340 DOI: 10.1007/s11934-016-0647-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose of Review The purpose of this study was to review the current evidence for quality of life (QOL) in patients with kidney stone disease (KSD). Recent Findings A review of literature from inception to May 2016 for all prospective English language articles on QOL in patients with KSD was done. QOL studies post urological procedures or ureteric stents were excluded. Nine studies (1570 patients) were included of which most (n = 6) used the SF-36 QOL tool. Overall, seven of the nine studies demonstrated a lower QOL in patients with KSD. Bodily pain and general health were significantly lower in patients with KSD compared to their control groups. Summary Patients with KSD have an overall lower QOL with most impact on bodily pain and general health domains. Compared to the scale of patients suffering from KSD, more work needs to be done in measuring QOL both in terms of ‘Stone specific’ QOL measuring tools and the quality/number of studies in this field.
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Affiliation(s)
- Francesca New
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, SO16 6YD, UK.
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Cavdar I, Temiz Z, Ozbas A, Can G, Tarhan F, Findik UY, Kutlu FY, Akyuz N. Sleep and quality of life in people with ileal conduit. Scand J Urol 2016; 50:472-476. [DOI: 10.1080/21681805.2016.1236834] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ikbal Cavdar
- Surgical Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey
| | - Zeynep Temiz
- Nursing Department, Faculty of Healthy Science, Artvin Coruh Universitesi, Artvin, Turkey
| | - Ayfer Ozbas
- Surgical Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey
| | - Gulbeyaz Can
- Medical Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey
| | - Fatih Tarhan
- Urology Department, Kartal Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey
| | - Ummu Yildiz Findik
- Nursing Department, Faculty of Healthy Science, Trakya University, Edirne, Turkey
| | - Fatma Yasemin Kutlu
- Mental Health and Psychiatric Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey
| | - Nuray Akyuz
- Surgical Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University, Istanbul, Turkey
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11
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Sloff M, Simaioforidis V, Tiemessen DM, Janke HP, Kortmann BBM, Roelofs LAJ, Geutjes PJ, Oosterwijk E, Feitz WFJ. Tubular Constructs as Artificial Urinary Conduits. J Urol 2016; 196:1279-86. [PMID: 27185613 DOI: 10.1016/j.juro.2016.04.092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE A readily available artificial urinary conduit might be substituted for autologous bowel in standard urinary diversions and minimize bowel associated complications. However, the use of large constructs remains challenging as host cellular ingrowth and/or vascularization is limited. We investigated large, reinforced, collagen based tubular constructs in a urinary diversion porcine model and compared subcutaneously pre-implanted constructs to cell seeded and basic constructs. MATERIALS AND METHODS Reinforced tubular constructs were prepared from type I collagen and biodegradable Vicryl® meshes through standard freezing, lyophilization and cross-linking techniques. Artificial urinary conduits were created in 17 female Landrace pigs, including 7 with a basic untreated construct, 5 with a construct seeded with autologous urothelial and smooth muscle cells, and 5 with a free graft formed by subcutaneous pre-implantation of a basic construct. All pigs were evaluated after 1 month. RESULTS The survival rate was 94%. At evaluation 1 basic and 1 cell seeded conduit were occluded. Urinary flow was maintained in all conduits created with pre-implanted constructs. Pre-implantation of the basic construct resulted in a vascularized tissue tube, which could be used as a free graft to create an artificial conduit. The outcome was favorable compared to that of the other conduits. Urinary drainage was better, hydroureteronephrosis was limited and tissue regeneration was improved. CONCLUSIONS Subcutaneous pre-implantation of a basic reinforced tubular construct resulted in a vascularized autologous tube, which may potentially replace bowel in standard urinary diversions. To our knowledge we introduce a straightforward 2-step procedure to create artificial urinary conduits in a large animal model.
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Affiliation(s)
- Marije Sloff
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Vasileios Simaioforidis
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorien M Tiemessen
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heinz P Janke
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara B M Kortmann
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc A J Roelofs
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul J Geutjes
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wout F J Feitz
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
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Ghosh A, Somani BK. Recent Trends in Postcystectomy Health-related Quality of Life (QoL) Favors Neobladder Diversion: Systematic Review of the Literature. Urology 2016; 93:22-6. [PMID: 27015941 DOI: 10.1016/j.urology.2015.12.079] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/16/2015] [Accepted: 12/02/2015] [Indexed: 11/30/2022]
Abstract
The study aims to review the current evidence for quality of life posturinary diversion surgery comparing neobladder to other types of diversion. A review of literature from inception to July 2015 for all English-language articles was done. Based on our inclusion criteria, 22 studies (2450 patients) were included. Whereas none of the prospective studies showed any quality of life (QoL) advantage with ileal conduit diversion, 3 of the 5 prospective studies and 4 of the 6 studies published after 2011 show better QoL outcomes with neobladder than other urinary diversion types. All prospective studies published after 2011 have shown neobladder to have superior QoL outcomes than its comparators. Recent trends indicate that orthotopic neobladder postcystectomy is associated with better QoL outcomes compared to other urinary diversion types.
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Affiliation(s)
- Anngona Ghosh
- University Hospital Southampton NHS Trust, Southampton, UK
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13
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Anderson CB, Rapkin B, Reaves BC, Sun AJ, Morganstern B, Dalbagni G, Donat M, Herr HW, Laudone VP, Bochner BH. Idiographic quality of life assessment before radical cystectomy. Psychooncology 2015; 26:206-213. [PMID: 26620583 DOI: 10.1002/pon.4025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 09/03/2015] [Accepted: 10/16/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND We sought to determine if idiographic, or self-defined, measures added to our understanding of patients with bladder cancer's quality of life (QOL) prior to radical cystectomy (RC). We tested whether idiographic measures increased prediction of global QOL beyond standard (nomothetic) measures of QOL components. METHODS We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (QLQ)-C30 and QLQ-BLM30, and our own idiographic Quality of Life Appraisal Profile prior to RC. Idiographic measures included number of goal statements, distance from goal attainment, and ability to complete goal attainment activities. Multivariate linear regression was used to predict measures of global QOL and related constructs of life satisfaction and mental health. RESULTS Two hundred fiftheen patients reported a median of 8 (interquartile range [IQR] 6, 11) goals and half had an average goal attainment rating above 6.9 out of 10 (IQR 5.5, 8.2). On multivariable analysis, QLQ-C30 role functioning and QLQ-BLM30 future perspective explained 15.7% of the variability in preoperative global QOL. Including goal attainment and activity difficulty explained an additional 12% of global QOL variance. Smaller gains were seen on measures of global health, life satisfaction, mental health, and activity, suggesting that idiographic measures capture aspects of QOL distinct from health and functional status defined by nomothetic scales. CONCLUSIONS Idiographic assessment of QOL added to prediction of global QOL above and beyond health-related components measured using nomothetic instruments. This self-defined information may be valuable in communicating with cancer patients about their QOL. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Christopher B Anderson
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Bruce Rapkin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Brieyona C Reaves
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Arony J Sun
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Bradley Morganstern
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Guido Dalbagni
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Machele Donat
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Harry W Herr
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Vincent P Laudone
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Bernard H Bochner
- Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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14
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Systematic review and meta-analysis of non RCT's on health related quality of life after radical cystectomy using validated questionnaires: Better results with orthotopic neobladder versus ileal conduit. Eur J Surg Oncol 2015; 42:343-60. [PMID: 26620844 DOI: 10.1016/j.ejso.2015.10.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/21/2015] [Accepted: 10/13/2015] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The current literature on the impact of different urinary diversions on patients' health related quality of life (HR-QoL) showed a marginally better quality of life scores of orthotopic neobladder (ONB) compared to ileal conduit (IC). The aim of this study was to update the review of all relevant published studies on the comparison between ONB and IC. MATERIALS AND METHODS Studies were identified by searching multiple literature databases, including MEDLINE, CINAHL, the Cochrane Library, PubMed Data were synthesized using meta-analytic methods conformed to the PRISMA statement. RESULTS The current meta-analysis was based on 18 papers that reported a HR-QoL comparison between IC and ONB using at least a validate questionnaire. Pooled effect sizes of combined QoL outcomes for IC versus ONB showed a slight, but not significant, better QoL in patients with ONB (Hedges' g = 0.150; p = 0.066). Patients with ileal ONB showed a significant better QoL than those with IC (Hedges' g = 0.278; p = 0.000); in case series with more than 65% males, ONB group showed a slight significant better QoL than IC (Hedges' g = 0.190; p = 0.024). Pooled effects sizes of all EORTC-QLQ-C30 aspects showed a significant better QoL in patients with ONB (Hedges' g = 0.400; p = 0.0000). CONCLUSIONS This meta-analysis of not-randomized comparative studies on the impact of different types of urinary diversions on HR-QoL showed demonstrated a significant advantage of ileal ONB compared to IC in terms of HR-QoL.
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Imbimbo C, Mirone V, Siracusano S, Niero M, Cerruto MA, Lonardi C, Artibani W, Bassi P, Iafrate M, Racioppi M, Talamini R, Ciciliato S, Toffoli L, Visalli F, Massidda D, D'Elia C, Cacciamani G, De Marchi D, Silvestri T, Creta M, Belgrano E, Verze P. Quality of Life Assessment With Orthotopic Ileal Neobladder Reconstruction After Radical Cystectomy: Results From a Prospective Italian Multicenter Observational Study. Urology 2015; 86:974-9. [PMID: 26291562 DOI: 10.1016/j.urology.2015.06.058] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/21/2015] [Accepted: 06/23/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess health-related quality of life (HRQoL) parameters in patients who received radical cystectomy (RC) with ileal orthotopic neobladder (IONB) reconstruction and to identify clinic-pathologic predictors of HRQoL. PATIENTS AND METHODS From January 2010 to December 2013, a multicenter, retrospective on 174 RC-IONB patients was carried out. All patients completed the following questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer-specific instruments (QLQ-BLM30) and the IONB-Patient Reported Outcome (IONB-PRO). Univariate and multivariate analyses were computed to identify clinic-pathologic predictors of HRQoL. RESULTS Median age was 66 years (range, 31-83), and 91.4% of patients were men. Median follow-up period was 37 months (range, 3-247). The EORTC QLQ-C30 revealed that age >65 years, absence of urinary incontinence, and absence of peripheral vascular disease were independent predictors of deteriorated body image. A follow-up > 36 months and the presence of urinary incontinence were independent predictors of worsened urinary symptoms, whereas the absence of urinary incontinence was an independent predictor of a worsened body image according to EORTC QLQ-BLM30 results. A follow-up >36 months and the absence of urinary incontinence were independent predictors of better functioning in terms of relational life, emotional life, and fatigue as revealed by the IONB-PRO. CONCLUSION Age, presence of urinary incontinence, length of follow-up, and comorbidity status may influence postoperative HRQoL and should all be taken into account when counseling RC-IONB patients.
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Affiliation(s)
- Ciro Imbimbo
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | | | - Mauro Niero
- TESIS Department, Verona University, Verona, Italy
| | | | | | | | | | | | - Marco Racioppi
- Department of Urology, University of Rome La Cattolica, Rome, Italy
| | | | | | - Laura Toffoli
- Department of Urology, Trieste University, Trieste, Italy
| | | | | | | | | | | | | | | | | | - Paolo Verze
- Department of Urology, University of Naples Federico II, Naples, Italy.
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Rabow MW, Benner C, Shepard N, Meng MV. Concurrent urologic and palliative care after cystectomy for treatment of muscle-invasive bladder cancer. Urol Oncol 2015; 33:267.e23-9. [PMID: 25814144 DOI: 10.1016/j.urolonc.2015.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 01/27/2015] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To characterize the effect of palliative care provided concurrently with usual urologic care for patients with bladder cancer undergoing cystectomy. MATERIALS AND METHODS Prospective, 6-month, serial cohort study comparing 33 participants receiving usual care with cystectomy for muscle-invasive bladder cancer, with 30 participants also receiving concurrent palliative care. Patients and family caregivers completed validated symptom assessment and satisfaction surveys preoperatively and at 2, 4, and 6 months postoperatively. RESULTS The intervention group saw improvements in most symptom measures over the 6 months following cystectomy compared with the control group. Depression and anxiety decreased over the 6-month period for the intervention group patients but increased over this time among the controls (P = 0.01). Fatigue decreased to a minimum for the intervention group participants at 4 months, whereas it peaked at this time for control participants (0.002). Quality-of-life and posttraumatic growth scores followed a similar pattern, with scores peaking at 4 months for the intervention group whereas controls reported their lowest scores at this time (P = 0.01 and P = 0.03, respectively). Changes in pain scores did not reach statistical significance. Neither family caregiver burden nor patient satisfaction showed statistically significant changes over time. CONCLUSIONS Patients who received concurrent palliative care in addition to usual urologic care following radical cystectomy for muscle-invasive bladder cancer had better outcomes, including improved fatigue, depression, quality of life, and posttraumatic growth. Although further research on this topic is needed, our results suggest that providing palliative care services in addition to usual urologic care for patients with bladder cancer may significantly reduce postoperative symptoms.
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Affiliation(s)
| | | | - Nancy Shepard
- Department of Nursing, Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA
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Abstract
Functional aspects and quality of life (QOL) of patients with a urinary diversion (UD) represent important issues in Urology. Any form of UD has its specific problems. In experienced hands and with regular long-term follow-up, serious complications can be avoided and excellent long-term results can be achieved. Thus, the selection of an appropriate UD is critical to patient's long-term satisfaction. Patients must be fully counseled in all types of UD and should have ready access to all options. There are 3 kinds of factors to be considered in the selection of UD: patient, physician, and general factors. In the pre-operative counseling, it is mandatory to explain all factors that over time may contribute to affect the patient's urinary tract function and QOL, mainly linked to long-term complications of UD. One of the most important requirements for any bladder substitution is that it should not jeopardize the renal function. There are many urological and non-urological potential reasons for deterioration in renal function following UD. Continence results after neobladder (NB) are difficult to compare between series published in the literature because of a lack of consensus of definitions, varied follow-up periods, and different mechanisms of data collection. In up to 22% of patients with NB, significant residual urine volumes were observed. The overall patients' QOL reported in most articles was good, irrespective of the type of UD. QOL of patients with a well functioning NB seems to be significantly better than other forms of diversion. Well-designed randomized prospective trials are warranted to render definitive conclusions.
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18
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Tejido-Sánchez A, García-González L, Jiménez-Alcaide E, Arrébola-Pajares A, Medina-Polo J, Villacampa-Aubá F, Díaz-González R. Quality of life in patients with ileal conduit cystectomy due to bladder cancer. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.acuroe.2013.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tejido-Sánchez A, García-González L, Jiménez-Alcaide E, Arrébola-Pajares A, Medina-Polo J, Villacampa-Aubá F, Díaz-González R. Quality of life in patients with ileal conduit cystectomy due to bladder cancer. Actas Urol Esp 2014; 38:90-5. [PMID: 23850163 DOI: 10.1016/j.acuro.2013.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/16/2013] [Accepted: 04/21/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the variables that affect quality of life of patients treated by radical cystectomy with ileal conduit. MATERIAL AND METHOD We analyzed quality of life using the EQ-5D-3L questionnaire. This questionnaire evaluates mobility, personal care, daily activities, pain/discomfort, anxiety/depression and a self-rating scale of the health condition. We compared the result with demographic variables (gender, age, work situation, studies, income, partner) and clinical variables (ASA classification, tumor stage, time since cystectomy was performed, adjuvant chemotherapy, recurrent and complications of the stoma). The statistical analysis included a descriptive study, univariate and multivariate analysis. RESULTS A total of 59 patients were included in the study, with a mean age of 69 years (47-84). Mean time from cystectomy was 43 months (12-83), with 61% complications associated to the stoma. Stoma complications were related with limitations in personal care, pain/discomfort, anxiety, depression and quality of life in general. Female gender was associated with limitations in daily activities and adjuvant chemotherapy with anxiety/depression and quality of life in general. The rest of the variables were not statistically significant in the multivariate analysis. CONCLUSIONS The limitations in quality of life in patients with cystectomy and ileal conduit are associated with the stoma-associated complications. Other related variables are female gender and administration of adjuvant chemotherapy.
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Benner C, Greenberg M, Shepard N, Meng MV, Rabow MW. The natural history of symptoms and distress in patients and families following cystectomy for treatment of muscle invasive bladder cancer. J Urol 2013; 191:937-42. [PMID: 24184369 DOI: 10.1016/j.juro.2013.10.101] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE We characterized the natural history of symptoms with time in patients with bladder cancer undergoing cystectomy. MATERIALS AND METHODS For 6 months we followed 33 participants treated with muscle invasive bladder cancer treatment with cystectomy in this prospective cohort study. Patients and family caregivers completed validated symptom assessment and satisfaction surveys at baseline, and 2, 4 and 6 months later. Primary outcomes were the change from baseline in pain, fatigue, depression, anxiety, quality of life and spiritual well-being. Secondary outcomes included posttraumatic growth, patient satisfaction and family caregiver burden. RESULTS Pain increased after radical cystectomy and remained increased 6 months postoperatively based on Brief Pain Inventory scores (baseline and 6-month scores 4.0, 95% CI 0-8.0 and 9.8, 95% CI 1.9-17.6, respectively, p = 0.03). Posttraumatic growth showed a trend toward an increase at 2 months (p = 0.06). Fatigue peaked at 4 months but did not change significantly with time (p = 0.12). There was similarly no significant change with time in depression, anxiety, quality of life, spiritual well-being or satisfaction. Neither family caregiver burden nor satisfaction showed a statistically significant change with time postoperatively. CONCLUSIONS Pain increased after radical cystectomy and remained increased 6 months postoperatively. There was a trend toward increased posttraumatic growth at 2 months. Otherwise, by 6 months cystectomy was associated with no improvement in preoperative symptoms of fatigue, quality of life, spiritual well-being, depression or anxiety. After cystectomy pain should be assessed and treated more aggressively in patients with bladder cancer and efforts should be made to improve postoperative symptoms.
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Affiliation(s)
- Carly Benner
- Division of General Internal Medicine, University of California-San Francisco, San Francisco, California.
| | - Molly Greenberg
- Division of General Internal Medicine, University of California-San Francisco, San Francisco, California
| | - Nancy Shepard
- Department of Nursing, Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, California
| | - Maxwell V Meng
- Department of Urology, University of California-San Francisco, San Francisco, California
| | - Michael W Rabow
- Division of General Internal Medicine, University of California-San Francisco, San Francisco, California
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Goossens - Laan CA, Kil PJM, Bosch JLHR, De Vries J. Patient-reported outcomes for patients undergoing radical cystectomy: a prospective case–control study. Support Care Cancer 2013; 22:189-200. [PMID: 24026979 DOI: 10.1007/s00520-013-1946-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022]
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Quality of life in patients with muscle invasive and non-muscle invasive bladder cancer. Support Care Cancer 2012; 21:1383-93. [PMID: 23238655 DOI: 10.1007/s00520-012-1680-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/27/2012] [Indexed: 12/17/2022]
Abstract
PURPOSE Compared to the literature on other malignancies, data on quality of life (QoL) in bladder cancer are sparse. This study sought answers to the following questions: In what QoL domains do patients with bladder cancer differ from the general population? Do patients with radical cystectomy differ in QoL compared to those who received conservative treatment? Do patients with neobladder generally have better QoL compared to patients with other diversion methods? METHODS At the beginning of inpatient rehabilitation, N = 823 patients with bladder cancer were assessed. Data of a representative community sample (N = 2037) were used for comparison. The questionnaire EORTC QLQ-C30 was used to measure QoL. Multivariate linear regression models were computed to investigate differences between groups. RESULTS Patients with both non-muscle invasive and muscle invasive bladder cancer reported significantly more problems and worse functioning than the general population. Radiotherapy is associated with clinically relevant more pain, dyspnoea, constipation, appetite loss and decreased social functioning while chemotherapy is associated more with dyspnoea. Cystectomy patients reported more fatigue, appetite loss and decreased role functioning. Male patients ≥70 years with conduit experienced more sleep and emotional problems. These effects of urinary diversion were not observed in women and younger patients. CONCLUSIONS Patients with bladder cancer experience various QoL concerns at the beginning of inpatient rehabilitation. These problems can partly be explained by the type of treatment the patients receive. Type of urinary diversion is relevant for QoL in subgroups of patients.
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Goossens-Laan CA, Kil PJM, Ruud Bosch JLH, De Vries J. Pre-diagnosis quality of life (QoL) in patients with hematuria: comparison of bladder cancer with other causes. Qual Life Res 2012; 22:309-15. [PMID: 22461137 PMCID: PMC3576555 DOI: 10.1007/s11136-012-0163-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE To examine quality of life (QoL), health status, sexual function, and anxiety in patients with primary hematuria who later appear to have bladder cancer (BC) and patients with other diagnoses. METHODS From July 2007 to July 2010, 598 patients with primary hematuria were enrolled in this prospective, multicenter study. Questionnaires (WHOQOL-BREF, SF-12, IIEF, STAI-10-item Trait) were completed before cystoscopy. Diagnosis was subsequently derived from medical files. BC patients were compared with patients with other causes of hematuria. RESULTS Cancer was diagnosed in 131 patients (21.9 %), including 102 patients (17.1 %) with BC. No differences were found in the WHOQOL-BREF versus SF-12 psychological or physical health domains. The erectile function was significantly worse in the BC group (9.3 vs. 14.6 for OC, p = 0.02). Patients with muscle-invasive BC (MIBC) had the lowest percentage anxious personalities of all BC patients (p = 0.04). CONCLUSIONS Cancer was found in 21.9 % of the patients with hematuria. Pre-diagnosis patients with BC have comparable QoL and HS to patients with OC. Erectile dysfunction was highest in patients with BC. MIBC patients had the lowest percentage anxious personalities of the patients with BC.
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Affiliation(s)
- Catharina A Goossens-Laan
- Department of Urology, University Medical Centre Utrecht, HP:C04.236, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
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Current world literature. Curr Opin Urol 2011; 21:535-40. [PMID: 21975510 DOI: 10.1097/mou.0b013e32834c87d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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