Hangchuan Shi1,2, Han Yu3, Joaquim Bellmunt4, Jeffrey J Leow4, Xuanyu Chen1, Changcheng Guo5, Hongmei Yang6, Xiaoping Zhang7. 1. Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China. 2. Clinical and Translational Science Institute, University of Rochester, Rochester, NY, 14642, USA. 3. Department of Biostatistics, The State University of New York at Buffalo, Buffalo, NY, 14214, USA. 4. Bladder Cancer Center, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, 02215, USA. 5. Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China. 6. Department of Pathogen Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. 7. Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China. xzhang@hust.edu.cn.
Abstract
PURPOSE: The question of whether orthotopic neobladder (ONB) reconstruction is superior to ileal conduit diversion (ICD) with respect to health-related quality of life (HRQoL) remains controversial. The goal of this study is to perform a meta-analysis to compare post-ICD and post-ONB HRQoL in patients with bladder cancer. METHODS: A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and the annual congress abstracts of the European Association of Urology (EAU), the American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) up to June 2017 was conducted to identify all relevant clinical trials using validated questionnaires to assess HRQoL. A systematic review and meta-analysis were then performed. RESULTS: A total of 2507 patients from 26 eligible studies were included. Meta-analyses showed significant differences favouring ONB patients in global health status (WMD + 9.13, p = 0.004), physical functioning (WMD + 11.57, p = 0.0001), role functioning (WMD + 9.64, p = 0.002), and social functioning (WMD + 6.81, p = 0.03) based on the EORTC-QLQ-C30 questionnaire and in the total score of FACT questionnaire (WMD + 6.80, p = 0.001). However, ONB patients were more likely to have postoperative urinary symptoms than ICD patients (WMD - 22.19, p = 0.0001). CONCLUSIONS: ONB patients are more likely to have a better global health status than ICD patients. Regardless of the type of urinary diversion (UD) surgery, a gradual improvement in HRQoL over preoperative status tended to stabilise after 12 months postoperatively.
PURPOSE: The question of whether orthotopic neobladder (ONB) reconstruction is superior to ileal conduit diversion (ICD) with respect to health-related quality of life (HRQoL) remains controversial. The goal of this study is to perform a meta-analysis to compare post-ICD and post-ONB HRQoL in patients with bladder cancer. METHODS: A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and the annual congress abstracts of the European Association of Urology (EAU), the American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) up to June 2017 was conducted to identify all relevant clinical trials using validated questionnaires to assess HRQoL. A systematic review and meta-analysis were then performed. RESULTS: A total of 2507 patients from 26 eligible studies were included. Meta-analyses showed significant differences favouring ONB patients in global health status (WMD + 9.13, p = 0.004), physical functioning (WMD + 11.57, p = 0.0001), role functioning (WMD + 9.64, p = 0.002), and social functioning (WMD + 6.81, p = 0.03) based on the EORTC-QLQ-C30 questionnaire and in the total score of FACT questionnaire (WMD + 6.80, p = 0.001). However, ONB patients were more likely to have postoperative urinary symptoms than ICDpatients (WMD - 22.19, p = 0.0001). CONCLUSIONS: ONB patients are more likely to have a better global health status than ICDpatients. Regardless of the type of urinary diversion (UD) surgery, a gradual improvement in HRQoL over preoperative status tended to stabilise after 12 months postoperatively.
Entities:
Keywords:
Bladder cancer; Meta-analysis; Quality of life; Urinary diversion
Authors: Scott M Gilbert; Rodney L Dunn; Brent K Hollenbeck; James E Montie; Cheryl T Lee; David P Wood; John T Wei Journal: J Urol Date: 2010-03-17 Impact factor: 7.450
Authors: Mohamed H Zahran; Diaa-Eddin Taha; Ahmed M Harraz; Essam M Zidan; Mona A El-Bilsha; Mohamed Tharwat; Ahmed S El Hefnawy; Bedeir Ali-El-Dein Journal: Minerva Urol Nefrol Date: 2016-09-29 Impact factor: 3.720
Authors: J Alfred Witjes; Eva Compérat; Nigel C Cowan; Maria De Santis; Georgios Gakis; Thierry Lebret; Maria J Ribal; Antoine G Van der Heijden; Amir Sherif Journal: Eur Urol Date: 2013-12-12 Impact factor: 20.096
Authors: Meng Xiao; Fan Zhang; Nanzi Xiao; Xiaoqing Bu; Xiaojun Tang; Qian Long Journal: Int J Environ Res Public Health Date: 2019-07-03 Impact factor: 3.390
Authors: Daniela Fasanella; Michele Marchioni; Luigi Domanico; Claudia Franzini; Antonino Inferrera; Luigi Schips; Francesco Greco Journal: Life (Basel) Date: 2022-08-04