HEALTH RELATED QUALITY OF LIFE AFTER RADICAL CYSTECTOMY AND URINARY DIVERSION FOR BLADDER CANCER: A SYSTEMATIC REVIEW AND CRITICAL ANALYSIS OF THE LITERATURE

No AccessJournal of UrologyAdult Urology: Outcomes/Epidemiology/Socioeconomics1 Apr 2005HEALTH RELATED QUALITY OF LIFE AFTER RADICAL CYSTECTOMY AND URINARY DIVERSION FOR BLADDER CANCER: A SYSTEMATIC REVIEW AND CRITICAL ANALYSIS OF THE LITERATURE MICHAEL P. PORTER and DAVID F. PENSON MICHAEL P. PORTERMICHAEL P. PORTER and DAVID F. PENSONDAVID F. PENSON View All Author Informationhttps://doi.org/10.1097/01.ju.0000149080.82697.65AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Continent forms of urinary diversion have become a gold standard of urinary tract reconstruction after radical cystectomy, based mostly on the premise of improved quality of life. It is unclear whether the existing body of literature supports this assumption. Materials and Methods: We performed a systematic review to determine if differences exist in health related quality of life (HRQOL) outcomes among different types of urinary diversion after radical cystectomy. A MEDLINE search was performed inclusive of the dates 1966 to January 2004. Inclusion criteria included adult patients, patients with bladder cancer, comparative studies, original research, primary study outcome related to quality of life, and use of a quality of life instrument to measure outcomes. Only studies comparing neobladder, continent reservoir, or conduit diversion were included. Results: Of 378 initial articles 15 studies met all inclusion criteria. None of the studies were randomized trials. Only 1 study was prospective. Of 15 studies 10 (67%) used some type of previously validated HRQOL instrument, 10 (67%) used some form of ad hoc instrument, 11 (73%) used bladder cancer disease specific instruments, while 9 (60%) used general instruments. Only 1 of the bladder cancer specific instruments had been previously validated. Common limitations included unvalidated HRQOL instruments, use of general HRQOL instruments only, lack of baseline data, cross- sectional analysis, and retrospective study design. Conclusions: To date, the current body of published literature is insufficient to conclude that 1 form of urinary diversion is superior to another based on HRQOL outcomes. Future studies should attempt to incorporate prospective data collection, longer term followup and validated disease specific HRQOL instruments. References 1 : Contemporary cystectomy and urinary diversion. World J Urol2002; 20: 151. Google Scholar 2 : Which patients with transitional cell carcinoma of the bladder or prostatic urethra are candidates for an orthotopic neobladder?. Curr Urol Rep2000; 1: 173. Google Scholar 3 : Cochrane Reviewers' Handbook 4.2.2. Chichester, United Kingdom: John Wiley & Sons, Ltd.2004. 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Link, Google Scholar From the Department of Urology, University of Washington, Seattle, Washington (MPP), and Departments of Urology and Preventative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (DFP)© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKhanna A, Saarela O, Lawson K, Finelli A, Haber G, Lee B and Abouassaly R (2019) Hospital Quality Metrics for Radical Cystectomy: Disease Specific and Correlated to Mortality OutcomesJournal of Urology, VOL. 202, NO. 3, (490-497), Online publication date: 1-Sep-2019.Leo M, Gilbert S, Wendel C, Krouse R, Grant M, Danforth K, Kwan M, Harrison T, Bulkley J and McMullen C (2019) Development of a Goal Elicitation Measure to Support Choice about Urinary Diversion by Patients with Bladder CancerJournal of Urology, VOL. 202, NO. 1, (83-89), Online publication date: 1-Jul-2019.Peyton C, Henriksen C, Reich R, Azizi M and Gilbert S (2018) Estimating Minimally Important Differences for the Bladder Cancer Index Using Distribution and Anchor Based ApproachesJournal of Urology, VOL. 201, NO. 4, (709-714), Online publication date: 1-Apr-2019.Perlis N, Krahn M, Boehme K, Alibhai S, Jamal M, Finelli A, Sridhar S, Chung P, Gandhi R, Jones J, Tomlinson G, Bremner K and Kulkarni G (2018) The Bladder Utility Symptom Scale: A Novel Patient Reported Outcome Instrument for Bladder CancerJournal of Urology, VOL. 200, NO. 2, (283-291), Online publication date: 1-Aug-2018.Gilbert S (2017) Editorial CommentJournal of Urology, VOL. 199, NO. 3, (674-675), Online publication date: 1-Mar-2018.Griebling T (2017) Re: Complications and Quality of Life in Elderly Patients with Several Comorbidities Undergoing Cutaneous Ureterostomy with Single Stoma or Ileal Conduit after Radical CystectomyJournal of Urology, VOL. 198, NO. 2, (230-230), Online publication date: 1-Aug-2017.Ritch C, Cookson M, Chang S, Clark P, Resnick M, Penson D, Smith J, May A, Anderson C, You C, Lee H and Barocas D (2014) Impact of Complications and Hospital-Free Days on Health Related Quality of Life 1 Year after Radical CystectomyJournal of Urology, VOL. 192, NO. 5, (1360-1364), Online publication date: 1-Nov-2014.Benner C, Greenberg M, Shepard N, Meng M and Rabow M (2013) The Natural History of Symptoms and Distress in Patients and Families Following Cystectomy for Treatment of Muscle Invasive Bladder CancerJournal of Urology, VOL. 191, NO. 4, (937-942), Online publication date: 1-Apr-2014.Silberstein J, Poon S, Maschino A, Lowrance W, Garg T, Herr H, Donat S, Dalbagni G, Bochner B and Sandhu J (2012) Urinary Diversion Practice Patterns Among Certifying American UrologistsJournal of Urology, VOL. 189, NO. 3, (1042-1047), Online publication date: 1-Mar-2013.Anderson C, Cookson M, Chang S, Clark P, Smith J and Kaufman M (2012) Voiding Function in Women with Orthotopic Neobladder Urinary DiversionJournal of Urology, VOL. 188, NO. 1, (200-204), Online publication date: 1-Jul-2012.Thulin H, Kreicbergs U, Wijkström H, Steineck G and Henningsohn L (2010) Sleep Disturbances Decrease Self-Assessed Quality of Life in Individuals Who Have Undergone CystectomyJournal of Urology, VOL. 184, NO. 1, (198-202), Online publication date: 1-Jul-2010.Gilbert S, Dunn R, Hollenbeck B, Montie J, Lee C, Wood D and Wei J (2010) Development and Validation of the Bladder Cancer Index: A Comprehensive, Disease Specific Measure of Health Related Quality of Life in Patients With Localized Bladder CancerJournal of Urology, VOL. 183, NO. 5, (1764-1770), Online publication date: 1-May-2010.Lowrance W, Rumohr J, Clark P, Chang S, Smith J and Cookson M (2009) Urinary Diversion Trends at a High Volume, Single American Tertiary Care CenterJournal of Urology, VOL. 182, NO. 5, (2369-2375), Online publication date: 1-Nov-2009.Lotan Y (2009) Editorial CommentJournal of Urology, VOL. 181, NO. 5, (2058-2059), Online publication date: 1-May-2009. Volume 173 Issue 4 April 2005 Page: 1318-1322 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsbladder cancerurinary diversionhealth related quality of lifecystectomyMetrics Author Information MICHAEL P. PORTER Dr. Porter is a Robert Wood Johnson Clinical Scholar whose position is supported financially by the Veteran's Administration. The opinions in this paper represent those of the authors and not necessarily those of the Robert Wood Johnson Foundation or the Veteran's Administration. More articles by this author DAVID F. PENSON Financial interest and/or other relationship with Pfizer, Inc., Sanofi-Synthelabo, Astra-Zeneca and Boehringer-Ingelheim. More articles by this author Expand All Advertisement PDF downloadLoading ...