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Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry.
Eur Urol 2015; 68(4):600-8EU

Abstract

BACKGROUND

Few studies have reported on late declines and long-term health-related quality of life (HRQOL) after prostate cancer (PCa) treatment.

OBJECTIVE

We assessed long-term HRQOL following various treatments for localized PCa.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study of HRQOL up to 10 yr after treatment used a prospectively accrued, nationwide PCa registry that collects longitudinal patient-reported HRQOL.

INTERVENTION

Various primary treatments for localized PCa.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The Medical Outcomes Studies 36-item Short Form and the University of California, Los Angeles, Prostate Cancer Index characterized physical function, mental health, and sexual, urinary, and bowel function and bother. Repeated measures mixed-model analysis assessed change in HRQOL by treatment over time, and logistic regression was used to measure the likelihood of a clinically significant decline in HRQOL.

RESULTS AND LIMITATIONS

Among 3294 men, 1139 (34%) underwent nerve-sparing radical prostatectomy (NSRP), 860 (26%) underwent non-NSRP, 684 (21%) underwent brachytherapy, 386 (12%) underwent external beam radiotherapy, 161 (5%) underwent primary androgen deprivation therapy, and 64 (2%) pursued watchful waiting/active surveillance. Median follow-up was 74 mo (interquartile range: 50-102). Most treatments resulted in early declines in HRQOL, with some recovery over the next 1-2 yr and a plateau in scores thereafter. Surgery had the largest impact on sexual function and bother and on urinary function, radiation had the strongest effect on bowel function, and androgen deprivation therapy had the strongest effect on physical function. The main limitation was attrition among the cohort.

CONCLUSIONS

Although most men experience initial declines in HRQOL in the first 2 yr after treatment, there is little change from 3 to 10 yr and most differences between treatments attenuated over time.

PATIENT SUMMARY

Various treatments for prostate cancer result in a distinct constellation of adverse effects on health-related quality of life, which may have a long-term impact. These findings are helpful regarding shared decision making over choice of primary treatment.

Authors+Show Affiliations

Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA. Electronic address: mcooperberg@urology.ucsf.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

25242555

Citation

Punnen, Sanoj, et al. "Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results From the CaPSURE Registry." European Urology, vol. 68, no. 4, 2015, pp. 600-8.
Punnen S, Cowan JE, Chan JM, et al. Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. Eur Urol. 2015;68(4):600-8.
Punnen, S., Cowan, J. E., Chan, J. M., Carroll, P. R., & Cooperberg, M. R. (2015). Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. European Urology, 68(4), pp. 600-8. doi:10.1016/j.eururo.2014.08.074.
Punnen S, et al. Long-term Health-related Quality of Life After Primary Treatment for Localized Prostate Cancer: Results From the CaPSURE Registry. Eur Urol. 2015;68(4):600-8. PubMed PMID: 25242555.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry. AU - Punnen,Sanoj, AU - Cowan,Janet E, AU - Chan,June M, AU - Carroll,Peter R, AU - Cooperberg,Matthew R, Y1 - 2014/09/18/ PY - 2014/06/01/received PY - 2014/08/29/accepted PY - 2014/9/23/entrez PY - 2014/9/23/pubmed PY - 2016/6/9/medline KW - HRQOL KW - Prostate cancer KW - Treatment SP - 600 EP - 8 JF - European urology JO - Eur. Urol. VL - 68 IS - 4 N2 - BACKGROUND: Few studies have reported on late declines and long-term health-related quality of life (HRQOL) after prostate cancer (PCa) treatment. OBJECTIVE: We assessed long-term HRQOL following various treatments for localized PCa. DESIGN, SETTING, AND PARTICIPANTS: This cohort study of HRQOL up to 10 yr after treatment used a prospectively accrued, nationwide PCa registry that collects longitudinal patient-reported HRQOL. INTERVENTION: Various primary treatments for localized PCa. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The Medical Outcomes Studies 36-item Short Form and the University of California, Los Angeles, Prostate Cancer Index characterized physical function, mental health, and sexual, urinary, and bowel function and bother. Repeated measures mixed-model analysis assessed change in HRQOL by treatment over time, and logistic regression was used to measure the likelihood of a clinically significant decline in HRQOL. RESULTS AND LIMITATIONS: Among 3294 men, 1139 (34%) underwent nerve-sparing radical prostatectomy (NSRP), 860 (26%) underwent non-NSRP, 684 (21%) underwent brachytherapy, 386 (12%) underwent external beam radiotherapy, 161 (5%) underwent primary androgen deprivation therapy, and 64 (2%) pursued watchful waiting/active surveillance. Median follow-up was 74 mo (interquartile range: 50-102). Most treatments resulted in early declines in HRQOL, with some recovery over the next 1-2 yr and a plateau in scores thereafter. Surgery had the largest impact on sexual function and bother and on urinary function, radiation had the strongest effect on bowel function, and androgen deprivation therapy had the strongest effect on physical function. The main limitation was attrition among the cohort. CONCLUSIONS: Although most men experience initial declines in HRQOL in the first 2 yr after treatment, there is little change from 3 to 10 yr and most differences between treatments attenuated over time. PATIENT SUMMARY: Various treatments for prostate cancer result in a distinct constellation of adverse effects on health-related quality of life, which may have a long-term impact. These findings are helpful regarding shared decision making over choice of primary treatment. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/25242555/Long_term_health_related_quality_of_life_after_primary_treatment_for_localized_prostate_cancer:_results_from_the_CaPSURE_registry_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(14)00844-6 DB - PRIME DP - Unbound Medicine ER -