Health Related Quality of Life of Patients with Bladder Cancer in the RAZOR Trial: A Multi-Institutional Randomized Trial Comparing Robot versus Open Radical Cystectomy

Maria F. Becerra, Vivek Venkatramani, Isildinha M. Reis, Nachiketh Soodana-Prakash, Sanoj Punnen, Mark L. Gonzalgo, Shyamal Raolji, Erik P. Castle, Michael E. Woods, Robert S. Svatek, Alon Z. Weizer, Badrinath R. Konety, Mathew Tollefson, Tracey L. Krupski, Norm D. Smith, Ahmad Shabsigh, Daniel A. Barocas, Marcus L. Quek, Atreya Dash, Dipen J. Parekh

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


PURPOSE: We evaluated health related quality of life following robotic and open radical cystectomy as a treatment for bladder cancer.

MATERIALS AND METHODS: Using the Randomized Open versus Robotic Cystectomy (RAZOR) trial population we assessed health related quality of life by using the Functional Assessment of Cancer Therapy (FACT)-Vanderbilt Cystectomy Index and the Short Form 8 Health Survey (SF-8) at baseline, 3 and 6 months postoperatively. The primary objective was to assess the impact of surgical approach on health related quality of life. As an exploratory analysis we assessed the impact of urinary diversion type on health related quality of life.

RESULTS: Analyses were performed in subsets of the per-protocol population of 302 patients. There was no statistically significant difference between the mean scores by surgical approach at any time point for any FACT-Vanderbilt Cystectomy Index subscale or composite score (p >0.05). The emotional well-being score increased over time in both surgical arms. Patients in the open arm showed significantly better SF-8 sores in the physical and mental summary scores at 6 months compared to baseline (p <0.05). Continent diversion (versus noncontinent) was associated with worse FACT-bladder-cystectomy score at 3 (p <0.01) but not at 6 months, and the SF-8 physical component was better in continent-diversion patients at 6 months (p=0.019).

CONCLUSIONS: Our data suggests lack of significant differences in the health related quality of life in robotic and open cystectomies. As robotic procedures become more widespread it is important to discuss this finding during counseling.

Original languageEnglish (US)
Pages (from-to)450-458
Number of pages9
JournalJournal of Urology
Issue number3
StatePublished - Sep 1 2020

Bibliographical note

Funding Information:
The RAZOR trial was supported by the National Institutes of Health National Cancer Institute (grant number RO1CA155388).

Publisher Copyright:
© 2020 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.


  • cystectomy
  • quality of life
  • urinary diversion
  • Robotic Surgical Procedures
  • Humans
  • Middle Aged
  • Urinary Bladder Neoplasms/surgery
  • Cystectomy/methods
  • Quality of Life
  • Female
  • Male
  • Aged

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Multicenter Study
  • Clinical Trial, Phase III
  • Journal Article
  • Comparative Study


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