@article {211069, title = {Variables affecting quality of life after Radical cystectomy and neobladder substitution: Egyptian National Cancer Institute experience.}, journal = {Progres en urologie : journal de l{\textquoteright}Association francaise d{\textquoteright}urologie et de la Societe francaise d{\textquoteright}urologie}, year = {2021}, abstract = {

INTRODUCTION: To evaluate the functional outcomes and quality of life beyond 1 year, in patients treated with radical cystectomy and orthotopic diversion for invasive bladder cancer. To investigate various potential contributing factors on patient{\textquoteright}s quality of life after radical cystectomy and urinary diversion via orthotopic neobladder.

MATERIALS AND METHODS: This retrospective study was conducted at the National Cancer Institute (NCI), Cairo; including a total of 97 patients who underwent radical cystectomy and orthotopic diversion. Functional and sexual outcome and patient QoL were assessed by ICIQ-SF, IIEF-5 and QLQ-C30 questionnaires. Potential association of patient QoL with pre-and intraoperative variables was studied.

RESULTS: Our results show that preoperative ECOG performance status 0 (P=0.0001), and nerve sparing surgery (P=0.001), were associated with high QoL and functional outcomes. On the contrary, ECOG performance status 2, preoperative comorbidities as ischemic heart diseases (P=0.01), recurrence (0.041), adjuvant chemotherapy (P=0.017) and radiotherapy (P=0.001) were associated with low QoL on univariate analysis. However, only ECOG performance status 2 (P\<0.0001), incontinence (P\<0.0001), non-nerve sparing surgery (P=0.001) and ureteric stricture (P=0.001) were independent predictors of worse QoL on multivariate analysis.

CONCLUSION: Orthotopic bladder is associated with increased morbidity. Attention should be given to preoprative patient characteristics at the time of patient selection, and intraoperative quality of functional preservation.

LEVEL OF EVIDENCE: 3.

}, author = {El Azab, A and Hossam, E and Abdelrahman, I and Aboulkassem, H and Fadlalla, W M and A Abdelbary} }