title: Prospective health-related quality of life analysis for patients undergoing radical cystectomy and urinary diversion.
abstract: OBJECTIVE
  To better define health-related quality of life (HRQOL) for patients undergoing radical cystectomy (RC) and urinary diversion.
  
  
  METHODS
  Patients undergoing RC and urinary diversion for urothelial carcinoma by 1 of 2 surgeons (G.D.S. or N.D.S.) had a HRQOL assessment at baseline and at follow-up using the validated, bladder cancer-specific Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index questionnaire. The primary outcome was change in HRQOL between baseline and follow-up.
  
  
  RESULTS
  From September 15, 2011, to July 23, 2012, 74 of 103 eligible patients were enrolled, and all but 1 completed the baseline Functional Assessment of Cancer Therapy-Vanderbilt Cystectomy Index leaving 73 patients in the study. Median age was 68 years (interquartile range, 60-74 years), 58 (78%) were Caucasian, 53 (73%) were ≥ cT2, 45 (62%) underwent incontinent diversion, and the mean age-adjusted Charlson Comorbidity Index score was 2.4 ± 1.8, with no significant differences among the 73 participants and 30 nonparticipants. The median time from surgery to response was 175 days (interquartile range, 102-232 days), and the response rate was 67%, with 9 deaths during follow-up. Baseline HRQOL scores did not significantly differ between respondents and nonrespondents or between those living vs deceased. Overall, RC-specific, physical, social, and functional HRQOL scores did not differ from baseline to follow-up, whereas emotional HRQOL scores were significantly improved (15.7 ± 5.8 vs 18.1 ± 3.9, P = .03). Overall or domain-specific HRQOL measures did not differ significantly between patients undergoing incontinent (n = 27) vs continent (n = 16) diversions.
  
  
  CONCLUSIONS
  Overall, HRQOL scores did not statistically differ from baseline to the median 6-month follow-up for patients undergoing RC and urinary diversion for urothelial carcinoma. Patients undergoing continent vs incontinent urinary diversions had similar overall HRQOL scores at follow-up.
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL; Urology of Indiana, Greenwood, IN.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Large
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Rena
authors.initials: R
authors.lastname: Malik
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cohn
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL. Electronic address: krichards112@gmail.com.
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Richards
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Cory
authors.initials: C
authors.lastname: Ganshert
authors.affiliation: Department of Statistics, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Rangesh
authors.initials: R
authors.lastname: Kunnavakkum
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Norm D
authors.initials: ND
authors.lastname: Smith
authors.affiliation: Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Steinberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D014547:Urinary Diversion