MP60-16 THREE-MONTH PATIENT-REPORTED OUTCOMES AFTER OPEN VERSUS ROBOTIC RADICAL CYSTECTOMY: A RANDOMIZED CLINICAL TRIAL

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2014MP60-16 THREE-MONTH PATIENT-REPORTED OUTCOMES AFTER OPEN VERSUS ROBOTIC RADICAL CYSTECTOMY: A RANDOMIZED CLINICAL TRIAL Michael Feuerstein, Michael Goltzman, Bradley Morganstern, Nicole Roberts, Sara Blass, Ahmad Shabsigh, Yuelin Li, Jonathan Coleman, S. Machele Donat, Harry Herr, Guido Dalbagni, Vincent Laudone, Bruce Rapkin, and Bernard Bochner Michael FeuersteinMichael Feuerstein More articles by this author , Michael GoltzmanMichael Goltzman More articles by this author , Bradley MorgansternBradley Morganstern More articles by this author , Nicole RobertsNicole Roberts More articles by this author , Sara BlassSara Blass More articles by this author , Ahmad ShabsighAhmad Shabsigh More articles by this author , Yuelin LiYuelin Li More articles by this author , Jonathan ColemanJonathan Coleman More articles by this author , S. Machele DonatS. Machele Donat More articles by this author , Harry HerrHarry Herr More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , Vincent LaudoneVincent Laudone More articles by this author , Bruce RapkinBruce Rapkin More articles by this author , and Bernard BochnerBernard Bochner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1770AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Radical cystectomy can have a profound quality of life impact for patients. Prior studies of the purported differences between open and robotic cystectomy techniques have primarily been retrospective, heavily based upon surgical outcomes, and with potential for several major biases. We provide our prospective data evaluating short-term, patient-reported outcomes (PRO) obtained during a randomized clinical trial of open versus robotic radical cystectomy. Methods Prior to radical cystectomy, patients at our institution were recruited for two concurrent, prospective studies, a longitudinal PRO study and a randomized trial comparing open versus robotic radical cystectomy with extracorporeal urinary diversion. We conducted a post-hoc comparison of PRO outcomes in 110 patients enrolled in both studies using the EORTC QLQ-C30, a validated, cancer-related PRO instrument that measures general quality-of-life, functioning and symptoms. EORTC scores were scaled from 0 to 100 using linear transformation. ANOVA was performed for the change in score from pre-cystectomy and 3-months between open and robotic groups. A correlation matrix was then performed to evaluate PRO by randomized-status and urinary diversion type. Results 118 patients were recruited to the randomized study of which 110 (93%) were enrolled in our PRO study. 79 of 110 (72%) patients returned pre-cystectomy surveys. 54 (68%) of these patients, including 32 and 22 in open and robotic arms respectively, also completed 3-month postoperative PRO surveys. No differences in 3-month change in general quality of life, functioning or symptoms were found between open and robotic radical cystectomy groups (Table). Interestingly, patients that underwent orthotopic neobladder compared to ileal conduit reported worse diarrhea (-16.6 vs -6.5 change at 3 months, p=0.010). This difference was more significant in the robotic group (-28.6 vs -3.7, p=0.004) than in the open group (-10.5 vs 0, p=0.021). Conclusions At 3 months following surgery, patients reported no differences in general quality of life, functioning or symptoms between open and robotic radical cystectomy. These findings provide evidence of minimal perceived difference between open versus robotic radical cystectomy at 3 months. Verification in a larger sample at multiple time intervals is warranted. Change in Quality of Life at 3-months Post-Cystectomy N Pearson Correlation P-value (2-tailed) General QOL 53 0.05 0.7 Physical Function 54 0.1 0.3 Role Function 54 -0.01 0.9 Emotional Function 54 0.1 0.5 Cognitive Function 54 -0.05 0.7 Social Function 54 0.04 0.8 Fatigue 54 -0.09 0.5 Nausea 54 -0.1 0.5 Pain 54 -0.02 0.9 Dyspnea 54 0.1 0.4 Insomnia 54 -0.08 0.6 Appetite Loss 54 -0.06 0.7 Constipation 54 0.1 0.3 Diarrhea 54 0.2 0.2 Financial Concerns 52 0.1 0.4 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e638-e639 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Michael Feuerstein More articles by this author Michael Goltzman More articles by this author Bradley Morganstern More articles by this author Nicole Roberts More articles by this author Sara Blass More articles by this author Ahmad Shabsigh More articles by this author Yuelin Li More articles by this author Jonathan Coleman More articles by this author S. Machele Donat More articles by this author Harry Herr More articles by this author Guido Dalbagni More articles by this author Vincent Laudone More articles by this author Bruce Rapkin More articles by this author Bernard Bochner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...