Quality of Life Assessment With Orthotopic Ileal Neobladder Reconstruction After Radical Cystectomy: Results From a Prospective Italian Multicenter Observational Study.
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.


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.


CONCLUSIONS
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.
Department of Urology, University of Naples Federico II, Naples, Italy.
Ciro
C
Imbimbo
Department of Urology, University of Naples Federico II, Naples, Italy.
Vincenzo
V
Mirone
Department of Urology, Trieste University, Trieste, Italy.
Salvatore
S
Siracusano
TESIS Department, Verona University, Verona, Italy.
Mauro
M
Niero
Department of Urology, Verona University, Verona, Italy.
Maria Angela
MA
Cerruto
TESIS Department, Verona University, Verona, Italy.
Cristina
C
Lonardi
Department of Urology, Verona University, Verona, Italy.
Walter
W
Artibani
Department of Urology, University of Rome La Cattolica, Rome, Italy.
Pierfrancesco
P
Bassi
Department of Urology, Padua University, Padua, Italy.
Massimo
M
Iafrate
Department of Urology, University of Rome La Cattolica, Rome, Italy.
Marco
M
Racioppi
Department of Urology, Trieste University, Trieste, Italy.
Renato
R
Talamini
Department of Urology, Trieste University, Trieste, Italy.
Stefano
S
Ciciliato
Department of Urology, Trieste University, Trieste, Italy.
Laura
L
Toffoli
Department of Urology, Trieste University, Trieste, Italy.
Francesco
F
Visalli
TESIS Department, Verona University, Verona, Italy.
Davide
D
Massidda
Department of Urology, Verona University, Verona, Italy.
Carolina
C
D'Elia
Department of Urology, Verona University, Verona, Italy.
Giovanni
G
Cacciamani
Department of Urology, Verona University, Verona, Italy.
Davide
D
De Marchi
Department of Urology, Trieste University, Trieste, Italy.
Tommaso
T
Silvestri
Department of Urology, University of Naples Federico II, Naples, Italy.
Massimiliano
M
Creta
Department of Urology, Trieste University, Trieste, Italy.
Emanuele
E
Belgrano
Department of Urology, University of Naples Federico II, Naples, Italy. Electronic address: pverze@gmail.com.
Paolo
P
Verze
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007558:Italy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D014549:Urinary Incontinence / Q000517:prevention & control; D016476:Urinary Reservoirs, Continent / Q000502:physiology*