Mp22-17 the Real Goal After Radical Cystectomy With Urinary Diversion: Survival and Quality of Life, Two Sides of the Moon

You have accessJournal of UrologyBladder Cancer: Invasive II (MP22)1 May 2024MP22-17 THE REAL GOAL AFTER RADICAL CYSTECTOMY WITH URINARY DIVERSION: SURVIVAL AND QUALITY OF LIFE, TWO SIDES OF THE MOON Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Simone D'Annunzio, Mariaconsiglia C. Ferriero, Leonardo Misuraca, Salvatore Guaglianone, Michele Gallucci, and Giuseppe Simone Riccardo MastroianniRiccardo Mastroianni , Gabriele TudertiGabriele Tuderti , Umberto AnceschiUmberto Anceschi , Alfredo Maria BoveAlfredo Maria Bove , Aldo BrassettiAldo Brassetti , Simone D'AnnunzioSimone D'Annunzio , Mariaconsiglia C. FerrieroMariaconsiglia C. Ferriero , Leonardo MisuracaLeonardo Misuraca , Salvatore GuaglianoneSalvatore Guaglianone , Michele GallucciMichele Gallucci , and Giuseppe SimoneGiuseppe Simone View All Author Informationhttps://doi.org/10.1097/01.JU.0001008608.50694.4b.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical Cystectomy (RC) with urinary diversion (UD) is still considered a complex surgery associated with significant morbidity and unfavorable impact on Health Related Quality of Life (HRQoL). Scientific community has mostly focused on surgical and survival outcomes, misevaluating HRQoL assessment. In this study we aimed to perform a model able to predict a new multidimensional GOAL, including objective (survival) and subjective (HRQoL) outcomes. Data were prospectively collected from an ongoing randomised controlled trial (RCT) comparing ORC and RARC with totally intracorporeal UD (NCT03434132). METHODS: Institutional review board approval was obtained. Between January 2018 and September 2020, patients with a diagnostic TURBt with cT2-4, cN0, cM0, or recurrent HG NMIBC were enrolled with a covariate adaptive randomization process based on the following variables: BMI, ASA score, baseline haemoglobin, planned UD [Padua ileal bladder or ileal conduit], neoadiuvant chemotherapy and cTstage. The GOAL was defined as the combination of two objective outcomes (alive and disease-free status) and unmodified global health status compared with baseline (subjectively assessed by means of self-assessed questionnaires (EORTC generic QLQ-C30 and QLQ-BLM30). Univariable and multivariable Cox regression analysis were performed in order to identify predictors of GOAL failure. Among secondary outcomes we performed a comparison analysis between ORC and RARC with totally intracorporeal UD. RESULTS: Baseline clinical features were reported (Table 1). Median age was 65 yrs, patients were predominantly male (72%) and the most commonly UD used was the PIB (76%). Out of 116 patients enrolled, 2 patients were lost to follow-up. Median follow-up was 22 mo (IQR 15-31). At multivariable Cox regression analysis, BMI (HR 1.08, 95% CI 1.01-1.15; p=0.029), 90d major complications (HR 2.56, 95% CI 1.26-5.17; p=0.009) and AJCC stage 3b (HR 4.79, 95% CI 2.21-10.36; p<0.001) were independent predictors of GOAL failure (Table 2 - Figure 1). No differences were observed between ORC and RARC with totally intracorporeal UD (Figure 2). CONCLUSIONS: This study highlights the independent role of BMI, 90d major complications and advanced AJCC stage as predictors of optimal postoperative course in the long run of RC with UD. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e349 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Simone D'Annunzio More articles by this author Mariaconsiglia C. Ferriero More articles by this author Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...