INTRODUCTION & OBJECTIVES: General and disease specific health-related quality of life (HRQOL) were assessed within the framework of a randomized trial to compare the outcomes of radical retropubie prostatectomy (RP) versus external beam radiotherapy (EBRT) in patients with clinically localized prostate cancer. MATERIAL & METHODS: Between 1997 and 2001, 137 patients were randomly treated with RP (n=70) or EBRT (n=67). Both groups included patients with comparable baseline characteristics. Before treatment and at 1, 3, 6, 12 and 24 months of follow-up, 96 valuable patients, 47 in RP and 49 in EBRT group, completed a questionnaire assessing the general HRQOL of life and specific changes in bowel, urinary and sexual functions. The questionnaire was validated by a test-retest pilot study. The repeated measures analysis of variance and analysis of covariance were conducted on all outcomes measures. All statistical tests were two-sided. RESULTS: In the first month after treatment, the RP group reported a significant decrease in general HRQOL than that observed in patients receiving EBRT (p<0.00l). At 3 months of follow-up, the general HRQOL differences among the groups were less striking, and at i2 months, the scores were not statistically different from the baseline scores in both treatment groups (p=0.431). After treatment the RP group showed a significantly lower urinary function score than the EBRT group (p<0.001). Urinary function improved with time during the first year after RP but remained fairly constant during year 2. Approximately 10.6% of RP and 2.9% of EBRT patients (OR-3.9, 95% confidence interval [CI]-1.4 to 5.9) were incontinent at 2 years. The EBRT group was associated with significant worse bowel fimction than the RP group throughout follow-up time (p<0.001). Approximately 26.5% of EBRT and 6.1% of RP patients (OR=0.23, 95% CI-0.1 to 0.5) had bowel dysfunction at 2 years. Sexual function was significantly better in EBRT than RP group just after treatment (p<0.001). During follow-up, the EBRT group showed a modest but statistically significant decline in sexual function, whereas the RP group improving over time. However, at 2 years sexual dysfunction was more prevalent in the RP than in the EBRT group (70.2% versus 61.2%; OR-2.5, 95% CI=1.6 to 3.8). The bothersome scores generally correlated with the functionality scores. CONCLUSIONS: A significant decrease in general HRQOL was evident only in the first month after RP. Patients undergoing RP report significantly worse urinary function, but better bowel function than those treated with EBRT. Both groups have a decline in sexual function throughout the post-treatment period. During the follow-up patients treated with EBRT began to show a continuing decline in erectile function.
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|Titolo:||General and disease specific health related quality of life after radical prostatectomy or external beam radiotherapy for localized prostate cancer.|
|Appare nelle tipologie:||1.5 Abstract in rivista|