HRQOL IN ELDERLY PATIENTS RECEIVING ILEAL CONDUIT OR ORTHOTOPIC NEOBLADDER

Aim: The aim of this study was to evaluate the health-related quality of life (HR-QoL) in elderly patients with invasive bladder cancer who received an ileal orthotopic neobladder (IONB) or an ileal conduit (IC) diversion. Patients and Methods: Files from 77 patients, aged 75 or older (median age=77), who received an IC (n=51) or an IONB (n=26) after radical cystectomy at 5 Italian institutions, were retrospectively reviewed. HR-QoL was evaluated by using the European Organisation for Research and Treatment of Cancer (EORTC) instruments quality of life questionnaire C30 (QLQ-C30) and QLQ muscle-invasive bladder cancer module (QLQ-BLM). Results: IC and IONB groups were comparable for all but one (gender) demographic and clinical variables. Actually, in the IC group, the number of females was significantly higher (12 versus 1, p= 0.029). At a mean follow- up of 60.91±42.19 months, mean scores in the IONB group were significantly better (higher in functional items and lower in symptoms items) in the following domains: cognitive functioning (95.87 vs. 81.05, p= 0.008), sleep disturbances (22.54 vs. 23.53, p= 0.048), appetite loss (5.13 vs. 18.95, p= 0.033), constipation (14 vs. 42.48, p= 0.001) and financial difficulties (1.28 vs. 7.84, p= 0.043). Considering only male patients, HR-QoL showed significant more favourable outcomes only in two symptoms items (constipation and appetite loss, p= 0.001 and p= 0.021, respectively). Conclusion: The results of our retrospective analysis suggest that, in terms of HR-QoL, IONB, when compared to IC, can be a suitable diversion for elderly patients with better favourable score for some functional and symptoms' aspects. These results may be affected by gender.