Health-related quality of life overview after different curative treatment options in muscle-invasive bladder cancer: an
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REVIEW
Health‑related quality of life overview after different curative treatment options in muscle‑invasive bladder cancer: an umbrella review Elke Rammant1 · Lisa Van Wilder2 · Mieke Van Hemelrijck3 · Nele S. Pauwels4 · Karel Decaestecker5 · Charles Van Praet5 · Renée Bultijnck1 · Piet Ost1,6 · Thomas Van Vaerenbergh1 · Sofie Verhaeghe7,8,9 · Ann Van Hecke7,9 · Valérie Fonteyne6 Accepted: 30 May 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose This umbrella review aims to evaluate the quality, summarize and compare the conclusions of systematic reviews investigating the impact of curative treatment options on health-related quality of life (HRQoL) in muscle-invasive bladder cancer (MIBC). Methods The Cochrane Library, MEDLINE, Embase and Web of Science were searched independently by two authors from inception until 06 January 2020. Systematic reviews and meta-analyses assessing the impact of any curative treatment option on HRQol in MIBC patients were eligible. Risk of bias was assessed using the AMSTAR 2 tool. Results Thirty-two reviews were included. Robot-assisted RC with extracorporeal urinary diversion and open RC have similar HRQoL (n = 10). Evidence for pelvic organ-sparing RC was too limited (n = 2). Patients with a neobladder showed better overall and physical HRQoL outcomes, but worse urinary function in comparison with ileal conduit (n = 17). Bladderpreserving radiochemotherapy showed slightly better urinary and sexual but worse gastro-intestinal HRQoL outcomes in comparison with RC patients (n = 6). Quality of the reviews was low in more than 50% of the available reviews and most of the studies included in the reviews were nonrandomized studies. Conclusion This umbrella review gives a comprehensive overview of the available evidence to date.
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02544-z) contains supplementary material, which is available to authorized users. * Elke Rammant [email protected] 1
Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium
2
Department of Public Health and Primary Care, University Hospital, Ghent University, Ghent, Belgium
3
School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King’s College London, London, UK
4
The Knowledge Center for Health Ghent, Ghent University, Ghent, Belgium
Bladder cancer (BC) is the 9th most common cancer worldwide with increasing incidence rates in men and people with more advanced age [1]. Thirty per cent of BC patients are diagnosed with muscle-invasive BC (MIBC, stages T2-T4) [2] and up to 45% of patients with non-MIBC (NMIBC) 5
Department of Urology, Ghent University Hospital, Ghent, Belgium
6
Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
7
Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
8
Department of Nur
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