HRQOL IN 112 MEN AND 33 WOMEN UNDERGOING ILEAL CONDUIT: EVALUATION IN LONG-TERM SURVIVORS

Introduction: Patients undergoing urinary radical cystectomy (RC) and urinary diversion for bladder cancer had some early and late complications and experience substantial limitations in health-related quality of life (HRQoL). There are just a few studies that have evaluated the levels of discomfort in long-term survivors (1-3). In the present study, we used the validated Italian version of QLQ-BLM30 and QLQ-C30 from European Organisation for Research and Treatment of Cancer (EORTC) to assess bladder cancer-specific HRQoL in men and women with ileal conduit (IC) after RC and with long term follow-up. Patients and Methods: From June 2007 to September 2013, a total of 145 consecutive patients with bladder cancer (112 male and 33 female), who underwent RC with IC from five urological academic centres, were included in this study. All patients had no evidence of tumor recurrence and were actively followed up. Clinical and pathological data, as well as clinical outcomes, were retrospectively analyzed. Quality of life was analyzed using Italian versions of the EORTC BLM30 and QLQ- C30 questionnaires. Mean values with standard deviations (±SD) were computed for all items. The Wilcoxon rank test was used to verify differences by sex in the long-term follow-up. Statistical significance was achieved if p -value was ≤0.05 (two-sides). Results: The median age of men was 72 years (range=49-95) and 71 years (range=52-86) in women undergoing IC. The median of follow-up was 34 months (range=49-95) in 112 men and 40 months (range=6-153) in the 33 women with IC. Our data showed that women with IC had greater problems than men in cognitive functioning (higher score means a better functionality) (77.3±27.9 and 87.8±18.6, respectively; p= 0.04) as well in future perspective (lower score means a low level of symptomatology/problems) (42.4±34.4 and 21.9±24.6, respectively; p= 0.001). In contrast, men, undergoing IC, had more problems in sexual functioning than women (23.3±24.5 and 7.0±20.3, respectively; p= 0.001). Discussion: Our study, based on long-term follow-up in women and men undergoing RC with IC, showed a better cognitive functioning and a more optimistic vision of the future in men than in women and a worse sexual function in men in comparison with women. Conclusion: RC and IC have a different impact in men and in women in relation to HRQoL in long-term.