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Comparison of health-related quality of life (HRQoL) between ileal conduit diversion and orthotopic neobladder based on validated questionnaires: a systematic review and meta-analysis

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Abstract

Purpose

The question of whether orthotopic neobladder (ONB) reconstruction is superior to ileal conduit diversion (ICD) with respect to health-related quality of life (HRQoL) remains controversial. The goal of this study is to perform a meta-analysis to compare post-ICD and post-ONB HRQoL in patients with bladder cancer.

Methods

A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and the annual congress abstracts of the European Association of Urology (EAU), the American Urological Association (AUA) and the Société Internationale d’Urologie (SIU) up to June 2017 was conducted to identify all relevant clinical trials using validated questionnaires to assess HRQoL. A systematic review and meta-analysis were then performed.

Results

A total of 2507 patients from 26 eligible studies were included. Meta-analyses showed significant differences favouring ONB patients in global health status (WMD + 9.13, p = 0.004), physical functioning (WMD + 11.57, p = 0.0001), role functioning (WMD + 9.64, p = 0.002), and social functioning (WMD + 6.81, p = 0.03) based on the EORTC-QLQ-C30 questionnaire and in the total score of FACT questionnaire (WMD + 6.80, p = 0.001). However, ONB patients were more likely to have postoperative urinary symptoms than ICD patients (WMD − 22.19, p = 0.0001).

Conclusions

ONB patients are more likely to have a better global health status than ICD patients. Regardless of the type of urinary diversion (UD) surgery, a gradual improvement in HRQoL over preoperative status tended to stabilise after 12 months postoperatively.

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Abbreviations

ICD:

Ileal conduit diversion

HRQoL:

Health-related quality of life

ONB:

Orthotopic neobladder

UD:

Urinary diversion

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Funding

This research was supported by the National Natural Science Foundation of China (Grant Nos. 81672528, 81702517).

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Authors and Affiliations

  1. Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China

    Hangchuan Shi, Xuanyu Chen & Xiaoping Zhang

  2. Clinical and Translational Science Institute, University of Rochester, Rochester, NY, 14642, USA

    Hangchuan Shi

  3. Department of Biostatistics, The State University of New York at Buffalo, Buffalo, NY, 14214, USA

    Han Yu

  4. Bladder Cancer Center, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA, 02215, USA

    Joaquim Bellmunt & Jeffrey J. Leow

  5. Department of Urology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, 200072, China

    Changcheng Guo

  6. Department of Pathogen Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Hongmei Yang

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  1. Hangchuan Shi
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Shi, H., Yu, H., Bellmunt, J. et al. Comparison of health-related quality of life (HRQoL) between ileal conduit diversion and orthotopic neobladder based on validated questionnaires: a systematic review and meta-analysis. Qual Life Res 27, 2759–2775 (2018). https://doi.org/10.1007/s11136-018-1902-8

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