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Short‐term quality‐of‐life assessed after robot‐assisted radical cystectomy: a prospective analysis
Author(s) -
Yuh Bertram,
Butt Zubair,
Fazili Anees,
Piacente Pamela,
Tan Wei,
Wilding Gregory,
Mohler James,
Guru Khurshid
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08070.x
Subject(s) - medicine , cystectomy , quality of life (healthcare) , extracorporeal , bladder cancer , surgery , urinary diversion , cancer , nursing
OBJECTIVE To prospectively determine the effect of robot‐assisted radical cystectomy (RARC) on quality of life (QoL) after surgery. PATIENTS AND METHODS In all, 34 patients who had RARC for bladder cancer between January 2006 and December 2007 at one institution were prospectively enrolled in a study of QoL. All patients had RARC with extracorporeal urinary diversion by one surgeon. As part of the routine follow‐up, QoL was assessed at intervals. Functional Assessment of Cancer Therapy‐Bladder (FACT‐BL) questionnaires were administered before and then over a 6‐month period after RARC. Patients undergoing chemotherapy were not excluded. Follow‐up FACT‐BL and individual domain scores for physical, social, emotional and functional well‐being were compared with those obtained before RARC. RESULTS The mean age of all patients was 65 years, 88% were men, and 13 (38%) had adjuvant chemotherapy. The mean time after RARC for the 1‐, 3‐ and 6‐month assessments was 29, 90 and 193 days, respectively; 19 patients completed three follow‐up questionnaires. Initially, there were significant decreases in the physical and functional domains, with improvements in the emotional domain ( P < 0.001). Total FACT‐General and FACT‐BL scores decreased in the initial period after RARC and then progressively improved. There was no statistically significant difference in total scores at 3 months after surgery; at the 6‐month follow‐up the total FACT‐BL scores exceeded those before RARC ( P = 0.048). CONCLUSIONS QoL appears to return promptly to, or exceed, baseline levels by 6 months after RARC. The improvement in the short term might allow for more contented patients and quicker initiation of adjuvant chemotherapy.