Aktuelle Urol 2020; 51(04): 363-370
DOI: 10.1055/a-1171-1213
Übersicht

Einfluss der radikalen Zystektomie auf die Lebensqualität und Strategien für deren Erhalt

The impact of radical cystectomy on health-related quality of life and potential for optimisation
Julia Rudolph
Universitätsklinikum Ulm, Klinik für Urologie und Kinderurologie, Ulm
,
Thomas Martini
Universitätsklinikum Ulm, Klinik für Urologie und Kinderurologie, Ulm
,
Felix Wezel
Universitätsklinikum Ulm, Klinik für Urologie und Kinderurologie, Ulm
› Author Affiliations

Zusammenfassung

Die radikale Zystektomie stellt einen wesentlichen Einschnitt in das Leben betroffener Patienten dar. Insbesondere ältere Patienten weisen nach radikaler Zystektomie oft eine begrenzte Lebenserwartung auf. Daher treten neben der reinen Tumortherapie insbesondere Aspekte der Lebensqualität in den Vordergrund.

In dieser narrativen Übersichtsarbeit wurden durch selektive Literaturrecherche Faktoren identifiziert, die einen Einfluss auf die Lebensqualität der betroffenen Patienten haben können. Dazu gehören neben Strategien zur Minimierung der perioperativen Morbidität eine optimale, individualisierte Therapieplanung. Diese sollte neben Faktoren wie Alter, Komorbiditäten, Wahl der Harnableitung auch altersspezifische, physiologische Gegebenheiten des Patienten wie die Gebrechlichkeit (Frailty) berücksichtigen. Patient-reported outcome measures (PROMs) sind essenzielle Instrumente, um die Lebensqualität standardisiert zu erfassen und sollten im klinischen Ablauf weiter etabliert werden.

Abstract

Radical cystectomy may have a major impact on the lives of affected patients. Older patients often have a reduced life expectancy after radical cystectomy. Therefore, aspects of health-related quality of life (HRQOL) have to be balanced against a solely tumour-directed therapy. In this narrative review, factors influencing the HRQOL of affected patients were identified and discussed by selective literature search.

Besides strategies to minimise perioperative morbidity, these include a patient-oriented and individualised treatment plan taking into account factors such as age, comorbidities, choice of urinary diversion and age-specific conditions, in particular frailty. Patient-reported outcome measures (PROMs) are crucial instruments to assess HRQOL outcomes and should be further implemented into routine clinical use.



Publication History

Article published online:
24 June 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 
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