Cancer Res Treat.  2019 Apr;51(2):556-567. 10.4143/crt.2018.221.

Health-Related Quality of Life Changes in Prostate Cancer Patients after Radical Prostatectomy: A Longitudinal Cohort Study

• Shin DW
• Lee SH
• Kim TH
• Yun SJ
• Nam JK
• Jeon SH
• Park SC
• Jung SI
• Park JH
• Park J

• KMID: 2464403
• DOI: http://doi.org/10.4143/crt.2018.221

Abstract

PURPOSE
Health-related quality of life (HRQOL) information related to radical prostatectomy (RP) is valuable for prostate cancer (PC) patients needing to make treatment decisions. We aimed to investigate HRQOL change in PC patients who underwent three types of RP (open, laparoscopic, or robotic) and compared their HRQOL with that of general population.
MATERIALS AND METHODS
Patients were prospectively recruited between October 2014 and December 2015. European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) and PC-specific module (PR25) were administered before surgery (baseline) and at postoperative 3 and 12 months. At each time point, HRQOL was compared, and a difference of 10 out of 0-100 scale was considered clinically significant.
RESULTS
Among 258 screened patients, 209 (41 open, 63 laparoscopic, and 105 robotic surgeries) were included. Compared to baseline, physical, emotional, and cognitive functioning improved at 12 months. Role functioning worsened at 3 months, but recovered to baseline at 12 months. Pain, insomnia, diarrhea, and financial difficulties also significantly improved at 12 months. Most PR25 scales excluding bowel symptoms deteriorated at 3 months. Urinary symptoms and incontinence aid recovered at 12 months, whereas sexual activity and sexual function remained poor at 12 months. Clinically meaningful differences in HRQOL were not observed according to RP modalities. Compared to the general population, physical and role functioning were significantly lower at 3 months, but recovered by 12 months. Social functioning did not recover.
CONCLUSION
Most HRQOL domains showed recovery within 12 months after RP, excluding sexual functioning and social functioning. Our findings may guide patients considering surgical treatment for PC.

Keyword

Health-related quality of life; Prostate neoplasms; Radical prostatectomy; Social function

MeSH Terms

Cohort Studies*
Diarrhea
Humans
Prospective Studies
Prostate*
Prostatectomy*
Prostatic Neoplasms*
Quality of Life*
Sexual Behavior
Sleep Initiation and Maintenance Disorders
Weights and Measures

Figure

• 

  Fig. 1. Changes in the QLQ-C30 functioning scales according to the type of radical prostatectomy (RP). a)Significant in comparison between laparoscopic or robotic RP and open RP at the same time point (either postoperative 3 or 12 months), b) Significant in comparison with baseline status within each group, c)Significant in comparison with status at postoperative 3 months within each group.

• 

  Fig. 2. Changes in the QLQ-C30 symptom scales according to the type of radical prostatectomy (RP). a)Significant in comparison between laparoscopic or robotic RP and open RP at the same time point (either postoperative 3 or 12 months), b) Significant in comparison with baseline status within each group, c) Significant in comparison with status at postoperative 3 months within each group.

• 

  Fig. 3. Changes in the QLQ-PR25 module according to the type of radical prostatectomy (RP). a)Significant in comparison between laparoscopic or robotic RP and open RP at the same time point (either postoperative 3 or 12 months), b)Significant in comparison with baseline status within each group, c)Significant in comparison with status at postoperative 3 months within each group.

• 

  Fig. 4. Comparison of the QLQ-C30 functioning scales and overall quality of life between matched prostate cancer patients and general population control. a)Significant in comparison with the baseline values of the general population control.

Reference

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