title: Quality-of-life outcomes and unmet needs between ileal conduit and orthotopic ileal neobladder after radical cystectomy in a Chinese population: a 2-to-1 matched-pair analysis.
abstract: BACKGROUND
  Health-related quality-of-life (HRQoL) is an important consideration after radical cystectomy (RC). Lack of effective ways to assess HRQoL after RC and unawareness of disease-specific problems related to ileal conduit (IC) and orthotopic ileal neobladder (OIN) are serious problems. The present study was to evaluate and compare morbidity and HRQoL between IC and OIN after RC, and examine their unmet needs in the two groups.
  
  
  METHODS
  A retrospective analysis was made of 294 patients treated with RC in our hospital between 2007 and 2013. Matched pair analysis was used to determine the patients of IC and OIN groups. Patient HRQoL between IC and OIN groups was assessed using the bladder-specific bladder cancer index (BCI) and European Organization for Research and Treatment of Cancer Body Image scale (BIS) questionnaires. Unmet information of patients undergoing these two urinary diversions was recorded through individual interviews.
  
  
  RESULTS
  Of the 117 included patients, 39 patients were treated with OIN and the other 78 matched patients with IC as controls for matched pair analysis. There was no significant difference in baseline characteristics between the two groups. OIN patients showed significantly better BIS scores in terms of HRQoL outcomes after RC at a short-term (<1 year) follow-up level, but there was no significant difference at a long-term (>1 year) follow-up level between the two groups. Interestingly, urinary bother (UB) and urinary function (UF) were poor in OIN patients at the one-year follow-up level, but there was no significant difference in UB between the two groups at the long term follow-up level. Unmet needs analysis showed that OIN patients had a more positive attitude towards treatment and participated in physical and social activities more positively, although they may have more urine leakage problems.
  
  
  CONCLUSIONS
  The mean BIS score in OIN group patients was significantly better than that in IC group patients at the one-year follow-up level, but there was no significant difference at the long-term follow-up level. Due attention should be paid to some particular unmet needs in individual patients in managing the two UD modalities.
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. huangyi198608@163.com.|Department of Urinary Surgery of Navy Hospital of Xiamen, No. 23, Zhenhai Road, Siming District, Xiamen, 361000, China. huangyi198608@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. panxiuwu@126.com.|Department of Urinary Surgery of Third Affiliated Hospital, Second Military Medical University, No. 700, Moyu Road, Jiading District, Shanghai, 201805, China. panxiuwu@126.com.
authors.forename: Xiuwu
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Urinary Surgery of No. 313 Hospital of PLA, No. 50, Haibinnan Road, Longgang District, Huludao City, Liaoning, 125000, China. zhouqwdoc@gmail.com.
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. yellowsea201314@163.com.
authors.forename: Hai
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. linclee880@gmail.com.|Department of Urinary Surgery of Third Affiliated Hospital, Second Military Medical University, No. 700, Moyu Road, Jiading District, Shanghai, 201805, China. linclee880@gmail.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Urinary Surgery of Third Affiliated Hospital, Second Military Medical University, No. 700, Moyu Road, Jiading District, Shanghai, 201805, China. xingangcui@126.com.
authors.forename: Xingang
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Stomatology of Changzheng Hospital, Second Military Medical University, Shanghai, China. louis_w@126.com.
authors.forename: Guodong
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. 541520625@qq.com.
authors.forename: Ren
authors.initials: R
authors.lastname: Jizhong
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. 328133501@qq.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. danfengxu_urology@163.com.
authors.forename: Danfeng
authors.initials: D
authors.lastname: Xu
authors.affiliation: Department of Urinary Surgery of Changzheng Hospital, Second Military Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, China. zandh@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hong
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D015653:Cystectomy / Q000523:psychology* / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000523:psychology* / Q000706:statistics & numerical data