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Quality of life and secondary outcomes for open versus robot-assisted radical cystectomy: a double-blinded, randomised feasibility trial

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Abstract

Purpose

This study aims to examine quality of life (QoL) before and after radical cystectomy (RC) and compare robot-assisted laparoscopy with intracorporeal urinary diversion (iRARC) to open radical cystectomy (ORC).

Methods

This study is a predefined secondary analysis of a single-centre, double-blinded, randomised feasibility trial. Fifty patients were randomly assigned to iRARC with ileal conduit (n = 25) or ORC with ileal conduit (n = 25). Patients were followed 90 days postoperatively. The primary outcome was patient-reported QoL using the EORTC Cancer-30 and muscle-invasive bladder cancer BLM-30 QoL questionnaires before and after RC. Differences between randomisation arms as well as changes over time were evaluated. Secondary outcomes included 30- and 90 day complication rates, 90 day readmission rates, and 90 day days-alive-and-out-of-hospital and their relationship to QoL.

Results

All patients underwent the allocated treatment. We found no difference in QoL, complication rates, readmission rates, and days-alive-and-out-of-hospital between randomisation arms. An overall improvement in QoL was found in the following domains: future perspectives, emotional functioning, and social functioning. Sexual functioning worsened postoperatively. There was no association between having experienced a major complication or lengthy hospitalisation and worse postoperative QoL.

Conclusion

The QoL does not appear to depend on surgical technique. Apart from sexual functioning, patients report stable or improved QoL within the first 90 postoperative days.

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Funding

This study was supported by the Department of Urology, Rigshospitalet and The Research Fund of Rigshospitalet, Copenhagen University Hospital. The Research Fund of Rigshospitalet, Copenhagen University Hospital did not have any role in the design and the conduct of this study.

Author information

Authors and Affiliations

  1. Urological Research Unit, Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Ole Maaloes Vej 24, unit 7521, DK-2100, Copenhagen, Denmark

    Maja Vejlgaard, Sophia Liff Maibom, Ulla Nordström Joensen & Martin Andreas Røder

  2. Department of Urology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

    Peter Ole Thind & Malene Rohrsted

  3. Department of Anaesthesiology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

    Eske Kvanner Aasvang

  4. Section for Surgical Pathophysiology, The Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark

    Henrik Kehlet

  5. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Maja Vejlgaard, Sophia Liff Maibom, Ulla Nordström Joensen, Peter Ole Thind, Malene Rohrsted, Eske Kvanner Aasvang, Henrik Kehlet & Martin Andreas Røder

Authors
  1. Maja Vejlgaard
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  2. Sophia Liff Maibom
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Contributions

MV contributed to data analysis and manuscript writing/editing. SLM and MAR was involved in protocol/project development; data collection/management; and manuscript editing. UNJ, EKA, and HK were involved in protocol/project development and manuscript editing. POT and MR contributed to protocol/project development.

Corresponding author

Correspondence to Maja Vejlgaard.

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Conflict of interest

The authors declare that there are no conflicts of interest.

Research involving human and animal participants

All procedures performed involving human participants were in accordance with the ethical standards of the Danish Scientific Ethical Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Supplementary Information

Below is the link to the electronic supplementary material.

345_2022_4029_MOESM1_ESM.xlsx

Supplementary Table 1: Quality of life for ORC vs. iRARC preoperatively and 90 days postoperatively, and the mean difference over time. ORC=open radical cystectomy, iRARC=robot-assisted radical cystectomy with intracorporeal urinary diversion, QoL=quality of life, QLQ-C30=quality of life questionnaire core 30, QLQ-BLM30=quality of life questionnaire muscle-invasive bladder cancer 30, IQR=interquartile range, SD=standard deviation. Supplementary Table 2: Quality of life preoperatively and 90 days postoperatively, and the mean difference over time. QoL=quality of life, QLQ-C30=quality of life questionnaire core 30, QLQ-BLM30=quality of life questionnaire muscle-invasive bladder cancer 30, IQR=interquartile range, SD=standard deviation. Supplementary file1 (XLSX 27 kb)

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Vejlgaard, M., Maibom, S.L., Joensen, U.N. et al. Quality of life and secondary outcomes for open versus robot-assisted radical cystectomy: a double-blinded, randomised feasibility trial. World J Urol 40, 1669–1677 (2022). https://doi.org/10.1007/s00345-022-04029-9

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  • DOI: https://doi.org/10.1007/s00345-022-04029-9

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