Oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy in bladder cancer patients: A single-center randomized trial

Vidal, Alvaro; Arnold, Nicolas; Vartolomei, Mihai Dorin; Kiss, Bernhard; Burkhard, Fiona C.; Thalmann, George; Roth, Beat (2016). Oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy in bladder cancer patients: A single-center randomized trial. International journal of urology, 23(12), pp. 992-999. Wiley 10.1111/iju.13228

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OBJECTIVES To prospectively evaluate the long-term oncological and functional outcomes of postoperative total parenteral nutrition after radical cystectomy. METHODS A total of 157 consecutive patients (≤cT3, cN0, cM0) who underwent extended pelvic lymph node dissection, radical cystectomy and ileal urinary diversion from September 2008 to March 2011 at a single center were randomized to receive either postoperative total parenteral nutrition (group A; n = 74) or oral nutrition alone (group B; n = 83). All but two patients in group B (who were thus excluded from further analysis) had regular postoperative follow up at the Department of Urology, University of Bern, Switzerland. Computed tomography and bone scan were carried out to assess local recurrences and distal metastases. We used validated questionnaires to evaluate bowel function, sexual function and quality of life, and an institutional questionnaire to evaluate neobladder function. RESULTS The median follow up was 50 months (IQR 21-62). The rate of local recurrences (4/74 [5.4%] in group A; 4/81 [4.9%] in group B; P = 0.9) and the rate of distant metastases (23/74 [31%] in group A; 23/81 [28%] in group B; P = 0.72) did not differ between the two groups. There was no difference in cancer-specific (P = 0.86) and overall survival (P = 0.85). Group B patients had significantly better bowel function at 3 months (P = 0.03) and 12 months (P = 0.01). There was no difference in terms of quality of life, and sexual and neobladder function. CONCLUSIONS The administration of total parenteral nutrition after radical cystectomy does not impair long-term oncological outcomes. It does, however, negatively influence long-term bowel function.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Kiss, Bernhard; Burkhard, Fiona C.; Thalmann, George and Roth, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1442-2042

Publisher:

Wiley

Language:

English

Submitter:

Katharina Morgenegg

Date Deposited:

14 Mar 2017 16:48

Last Modified:

14 Mar 2017 16:48

Publisher DOI:

10.1111/iju.13228

PubMed ID:

27770454

Uncontrolled Keywords:

bladder cancer; cystectomy; functional outcomes; oncological outcomes; parenteral nutrition

BORIS DOI:

10.7892/boris.93936

URI:

https://boris.unibe.ch/id/eprint/93936

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