Longitudinal Impact of Urinary Diversion on Health‐Related Quality of Life After Radical Cystectomy: A Multicenter Study in Japan

This multicenter longitudinal study was conducted across 24 institutions in Japan to examine the impact of urinary diversion on health-related quality of life (HRQOL) among bladder cancer patients who underwent radical cystectomy (RC). We evaluated bladder cancer-specific HRQOL and general HRQOL via the bladder cancer index (BCI) and the QOL General (QGEN-8), respectively, before the operation and at 3, 6, and 12 months postoperatively. The scores were compared across urinary diversion groups as well as across different time points within each urinary diversion group with linear mixed-effects models. Data from 227 patients were analyzed (151 with ileal conduits, 45 with ureterostomy, and 31 with neobladders). Neobladder patients were more likely to experience longitudinal impacts of their urinary diversion on urinary function than ileal conduit or ureterostomy patients were. Compared with that at baseline, the bowel function of neobladder patients remained impaired 12 months after surgery. All urinary diversion groups had worse sexual function scores at 3 and 6 months than at baseline, and the ileal conduit and neobladder groups had significantly worse sexual function scores at 12 months than at baseline. On the other hand, there was no significant difference in bother scores in the urinary, bowel, or sexual domain. The generic HRQOL was maintained from the preoperative to the postoperative period in all urinary diversion groups. This study explored longitudinal changes in HRQOL after RC, and the findings may help inform patient counseling regarding possible QOL trajectories.

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Journal
Cancer Science
Published
2026-01-04
DOI
https://doi.org/10.1111/cas.70289
Citations
1
Primary Topic
Bladder and Urothelial Cancer Treatments
Type
article
Field-Weighted Citation Impact
39.15

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Longitudinal Impact of Urinary Diversion on Health‐Related Quality of Life After Radical Cystectomy: A Multicenter Study in Japan

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article

Longitudinal Impact of Urinary Diversion on Health‐Related Quality of Life After Radical Cystectomy: A Multicenter Study in Japan

Toru Harabayashi, Sayaka Shimizu, Yoichi M. Ito, Fumihiko Urabe, Hiroshi Kitamura, Yoshiyuki Matsui, Ayako Takahashi, Katsuyoshi Hashine, Yohei Satake, Ataru Sazawa, Rikiya Taoka, Ken Morita, Shigetaka Suekane, Nobuo Shinohara, Atsuro Sawada, Yasuhiro Hashimoto, Shuhei Yamada, Shunichi Fukuhara, Shuichi Tatarano, Takanori Mochizuki, Takashi Kobayashi, Atsunari Kawashima, Akira Yokomizo, Junji Yatsuda, Takashi Matsumoto, Kohei Hashimoto, Jun Miki, the Japanese Urological Oncology Group, Keita Kobayashi, Miho Sato, Takahiro Kojima, Takahiro Osawa
article en
1 citations

Abstract

This multicenter longitudinal study was conducted across 24 institutions in Japan to examine the impact of urinary diversion on health-related quality of life (HRQOL) among bladder cancer patients who underwent radical cystectomy (RC). We evaluated bladder cancer-specific HRQOL and general HRQOL via the bladder cancer index (BCI) and the QOL General (QGEN-8), respectively, before the operation and at 3, 6, and 12 months postoperatively. The scores were compared across urinary diversion groups as well as across different time points within each urinary diversion group with linear mixed-effects models. Data from 227 patients were analyzed (151 with ileal conduits, 45 with ureterostomy, and 31 with neobladders). Neobladder patients were more likely to experience longitudinal impacts of their urinary diversion on urinary function than ileal conduit or ureterostomy patients were. Compared with that at baseline, the bowel function of neobladder patients remained impaired 12 months after surgery. All urinary diversion groups had worse sexual function scores at 3 and 6 months than at baseline, and the ileal conduit and neobladder groups had significantly worse sexual function scores at 12 months than at baseline. On the other hand, there was no significant difference in bother scores in the urinary, bowel, or sexual domain. The generic HRQOL was maintained from the preoperative to the postoperative period in all urinary diversion groups. This study explored longitudinal changes in HRQOL after RC, and the findings may help inform patient counseling regarding possible QOL trajectories.

Cancer ScienceVol. 117(3)
Kurume University (JP), Kagoshima University (JP), Jikei University School of Medicine (JP), University of Miyazaki (JP), Fukushima Medical University (JP), Kyushu University (JP), Sapporo Medical University (JP), Johns Hopkins University (US), University of Tsukuba (JP), Hirosaki University (JP), Yamaguchi University (JP), Tohoku University (JP), Sapporo University (JP), Kagawa University (JP), Hokkaido University (JP), Kyoto University (JP), Osaka City University (JP), National Hospital Organization Hokkaido Medical Center (JP), Obihiro Kosei General Hospital (JP), Aichi Cancer Center (JP), Jikei University Kashiwa hospital (JP), Shikoku Cancer Center (JP), Hokkaido University Hospital (JP), Harasanshin Hospital (JP), Tokyo National Hospital (JP), Hakodate National Hospital (JP), Kushiro City General Hospital (JP), University of Toyama (JP), University of Yamanashi (JP), Kumamoto University (JP), The University of Osaka (JP)
Bristol-Myers Squibb, Pfizer, AstraZeneca, Sanofi, Kissei, Nippon Shinyaku, Astellas Pharma, Chugai Pharmaceutical
Openalex Percentile: Top 2%
Bladder and Urothelial Cancer Treatments
39.15
DOIOpen Access PDFOpenAlex
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