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Japanese Journal of Clinical Oncology Advance Access published online on October 3, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl094
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© 2006 Foundation for Promotion of Cancer Research
Received May 16, 2006
Accepted July 9, 2006

Original Article

Assessment of Long-Term Quality of Life Using the FACT-BL Questionnaire in Patients with an Ileal Conduit, Continent Reservoir, or Orthotopic Neobladder

Eiji Kikuchi 1 *, Yutaka Horiguchi 2, Jun Nakashima 2, Takashi Ohigashi 2, Mototsugu Oya 2, Ken Nakagawa 2, Akira Miyajima 2, and Masaru Murai 2

1 Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
2 Department of Urology, Keio University School of Medicine, Tokyo, Japan

* To whom correspondence should be addressed.
Eiji Kikuchi, E-mail: eiji-k{at}kb3.so-net.ne.jp


  Abstract

Objective: To assess and compare quality of life (QOL) of patients followed for a long time who underwent an ileal conduit (IC), continent reservoir (CR) or ileal neobladder (NB) using FACT-BL, a bladder-cancer-specific questionnaire.

Methods: One hundred and forty-seven patients underwent radical cystectomy and urinary diversion for bladder cancer from 1987 to 2002 at our institution. Of them, 79 (54%) patients were asked to participate in this study. Forty-nine patients (20 IC, 14 CR and 15 NB) returned the answered questionnaire for a survey response rate of 62%. Mean follow-up was 83.0 months.

Results: Four categories (physical, social/familial, emotional and functional well-being) in FACT-G were equally favorable in these groups. Patients with IC had less trouble controlling urine but had a worse image on altered body appearance compared with NB patients. Interest in sex was extremely low in all patients and capability of maintaining an erection was also low in 39 male patients. The mean total value of FACT-BL in IC, CR and NB patients was 106.3 ± 16.4, 104.0 ± 14.2, and 110.9 ± 18.0, respectively, showing no significant difference. Ten (77%) of 13 IC, seven (78%) of nine CR and six (86%) of seven NB patients answered that they would choose the same type of diversion if they had the choice again.

Conclusions: The type of urinary diversion does not appear to be associated with a different QOL by general cancer-related assessment. Urinary function and body image are affected and related to the method used to reconstruct the urinary system.

Keywords: quality of life; total cystectomy; urinary diversion.
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