Health-related Quality of Life after Robotic-assisted vs Open Radical Cystectomy: Analysis of a Randomized Trial

Matthew B. Clements, Benjamin B. Beech, Thomas M. Atkinson, Guido M. Dalbagni, Yuelin Li, Andrew J. Vickers, Harry W. Herr, S. Machele Donat, Daniel D. Sjoberg, Amy L. Tin, Jonathan A. Coleman, Bruce D. Rapkin, Vincent P. Laudone, Bernard H. Bochner

Research output: Contribution to journalArticlepeer-review


Purpose:We compare health-related quality of life using a broad range of validated measures in patients randomized to robotic-assisted radical cystectomy vs open radical cystectomy.Methods:We retrospectively analyzed patients that had enrolled in both a randomized controlled trial comparing robotic-assisted laparoscopic radical cystectomy vs open radical cystectomy and a separate prospective study of health-related quality of life. The prospective health-related quality of life study collected 14 patient-reported outcomes measures preoperatively and at 3, 6, 12, 18, and 24 months postoperatively. Linear mixed-effects models with an interaction term (study arm×time) were used to test for differences in mean domain scores and differing effects of approach over time, adjusting for baseline scores.Results:A total of 72 patients were analyzed (n=32 robotic-assisted radical cystectomy, n=40 open radical cystectomy). From 3-24 months post-radical cystectomy, no significant differences in mean scores were detected. Mean differences were small in the following European Organization for Research and Treatment of Cancer QLQ-C30 (Core Quality of Life Questionnaire) domains: Global Quality of Life (-1.1; 95% CI -8.4, 6.2), Physical Functioning (-0.4; 95% CI -5.8, 5.0), Role Functioning (0.7; 95% CI -8.6, 10.0). Mean differences were also small in bladder cancer-specific domains (European Organization for Research and Treatment of Cancer QLQ-BLM30 [Muscle Invasive Bladder Cancer Quality of Life Questionnaire]): Body Image (2.9; 95% CI -7.2, 13.1), Urinary Symptoms (8.0; 95% CI -3.0, 19.0). In Urostomy Symptoms, there was a significant interaction term (P <.001) due to lower open radical cystectomy scores at 3 and 24 months. Other domains evaluating urinary, bowel, sexual, and psychosocial health-related quality of life were similar.Conclusions:Over a broad range of health-related quality of life domains comparing robotic-assisted radical cystectomy and open radical cystectomy, there are unlikely to be clinically relevant differences in the medium to long term, and therefore health-related quality of life over this time period should not be a consideration in choosing between approaches.

Original languageEnglish (US)
Pages (from-to)901-909
Number of pages9
JournalJournal of Urology
Issue number5
StatePublished - May 1 2023


  • carcinoma
  • cystectomy
  • quality of life
  • robotic surgical procedures
  • transitional cell
  • urinary bladder neoplasms

ASJC Scopus subject areas

  • Urology


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