Quality of Life in Bladder Cancer Patients Treated with Radical Cystectomy and Orthotopic Bladder Reconstruction versus Bladder Preservation Protocol

Abstract

Background: Tri-modality bladder sparing therapy in selected bladder cancer patients may be an alternatives treatment option to immediate radical cystectomy as it may result in satisfactory Quality Of Life (QOL). The present study evaluated the effects of this conservative approach versus surgical approach, i.e. Radical Cystectomy (RC) and orthotopic neobladder, on QOL of patients. Patients and methods: This is a prospective study of patients with bladder cancer in group I (using tri-modality bladder sparing therapy) and group II (using RC and orthotopic neobladder). Patients in both groups were subjected to interview NCCN-FACT FBlSI18 questionnaire, inquiring about physical and emotional disease related symptoms, treatment side effects and function and well being. SPSS version18 software was used for statistical analysis. Results: Internal consistency of the 18 items in both groups was assessed by Cronbach’s α which was adequate at 0.89 at Group I and 0.84 at Group II. Univariate analysis showed that there were statistically significant difference (p<0.05) in favor of group I patients compared to those in group II, regarding bladder function, potency and bowel symptoms. Multivariate analysis revealed that only T stage significantly affected physical and emotional disease related symptoms, and treatment side effects subscales in favor of bladder preservation group. Conclusions: Tri-modality bladder sparing therapy resulted in well-functioning bladders, mild bowel symptoms, and satisfactory sexual functioning in contrast to the surgical approach in bladder cancer patients and should be considered as a reasonable option for these patients.