Impacts of Urinary Diversions Associated with Cystectomy on the Quality of Life of Cancer Patients: Systematic Review and Meta-Analysis

ABSTRACT

Introduction:  Bladder cancer (BC) originates in the epithelium of the inner surface of the urinary bladder and involves hematuria and nonspecific symptoms of the lower urinary tract. The management of invasive BC is commonly performed by radical cystectomy with urinary diversion, with emphasis on the ileal conduit (IC) and continent diversion (CD) methods.

Objective:  To comparatively analyze the impacts on the quality of life of patients undergoing IC and CD associated with cystectomy for BC.

Method:  Systematic literature review with meta-analysis, which followed the recommendations of the PRISMA 2020 protocol. Data were collected from the online databases BVS, Scopus, PubMed, Web of Science, Embase, Cochrane Library and SciELO, organized by Rayyan QCRI and analyzed for their quality of evidence by the Joanna Briggs Institute critical scale. The meta-analysis was developed using the Review Manager 5.4.1 software.

Results:  Seven studies were included in the Review, of which four met the criteria for meta-analysis. In the analysis, no significant summary differences were identified between IC and DC in the "Global Health Scale", "Functional Capacity" and "Cognitive Capacity". The performance of DC prevailed in the "Physical Capacity" and "Emotional Capacity" domains. In contrast, a greater benefit of IC was observed in the "Social Capacity" of the individuals.

Conclusion:  Thus, although DC presented better results in the late postoperative period in some areas, the two methods presented similar results in a general analysis, evidencing the need for an individualized choice according to the patient's profile.

Key words:
Urinary Bladder Neoplasms/surgery; Surgical Oncology; Urinary Diversion/methods; Quality of Life; Sickness Impact Profile