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Yang L, Lee JA, Heer E, Pernar C, Colditz GA, Pakpahan R, Imm KR, Kim EH, Grubb RL, Wolin KY, Kibel AS, Sutcliffe S. One-year urinary and sexual outcome trajectories among prostate cancer patients treated by radical prostatectomy: a prospective study. BMC Urol 2021; 21:81. [PMID: 34001094 PMCID: PMC8130427 DOI: 10.1186/s12894-021-00845-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To examine one-year trajectories of urinary and sexual outcomes, and correlates of these trajectories, among prostate cancer patients treated by radical prostatectomy (RP). METHODS Study participants were recruited from 2011 to 2014 at two US institutions. Self-reported urinary and sexual outcomes were measured at baseline before surgery, and 5 weeks, 6 months and 12 months after surgery, using the modified Expanded Prostate Cancer Index Composite-50 (EPIC-50). Changes in EPIC-50 scores from baseline were categorized as improved (beyond baseline), maintained, or impaired (below baseline), using previously-reported minimum clinically important differences. RESULTS Of the 426 eligible participants who completed the baseline survey, 395 provided data on at least one EPIC-50 sub-scale at 5 weeks and 12 months, and were analyzed. Although all mean EPIC-50 scores declined markedly 5 weeks after surgery and then recovered to near (incontinence-related outcomes) or below (sexual outcomes) baseline levels by 12 months post-surgery, some men experienced improvement beyond their baseline levels on each sub-scale (3.3-51% depending on the sub-scale). Having benign prostatic hyperplasia (BPH) at baseline (prostate size ≥ 40 g; an International Prostate Symptom Index Score ≥ 8; or using BPH medications) was associated with post-surgical improvements in voiding dysfunction-related bother at 5 weeks (OR = 3.9, 95% CI: 2.1-7.2) and 12 months (OR = 3.3, 95% CI: 2.0-5.7); and in sexual bother at 5 weeks (OR = 5.7, 95% CI:1.7-19.3) and 12 months (OR = 3.0, 95% CI: 1.2-7.1). CONCLUSIONS Our findings provide additional support for considering baseline BPH symptoms when selecting the best therapy for early-stage prostate cancer.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Jung Ae Lee
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, USA
| | - Emily Heer
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
| | - Claire Pernar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Kellie R. Imm
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
- Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine of the
University of Southern California, 2001 N Soto St., Los Angeles, CA 90032 USA
| | - Eric H. Kim
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, USA
- Department of Urology, Medical University of South Carolina, Charleston, USA
- Coeus Health, Chicago, IL USA
- Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Boston, USA
- Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine of the
University of Southern California, 2001 N Soto St., Los Angeles, CA 90032 USA
| | - Robert L. Grubb
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, USA
- Department of Urology, Medical University of South Carolina, Charleston, USA
| | | | - Adam S. Kibel
- Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Boston, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
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Matsukawa K, Arimura T, Orita M, Kondo H, Chuman I, Ogino T, Taira Y, Kudo T, Takamura N. Health-related quality of life in Japanese patients with prostate cancer following proton beam therapy: an institutional cohort study. Jpn J Clin Oncol 2020; 50:519-527. [PMID: 32129447 PMCID: PMC7202140 DOI: 10.1093/jjco/hyaa027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/27/2020] [Accepted: 02/05/2020] [Indexed: 02/02/2023] Open
Abstract
Objective Many treatment options have guaranteed long-term survival in patients with localized prostate cancer and health-related quality of life has become a greater concern for those patients. The purpose of this study was to reveal the health-related quality of life after proton beam therapy and to clarify the differences from other treatment modalities for prostate cancer. Methods Between January 2011 and April 2016, 583 patients were enrolled in the study and health-related quality of life outcomes using the Expanded Prostate Cancer Index Composite questionnaire were evaluated and compared with previous research targeted at Japanese patients. Results We found a significant decrease in the least square mean scores for urinary and bowel domains excluding the incontinence subscale after proton beam therapy (P < 0.0001) and recovery at a year following treatment. The scores for sexual function in patients without androgen deprivation therapy decreased each year after proton beam therapy (P < 0.0001). The scores for hormones in patients without androgen deprivation therapy remained high and those of patients with androgen deprivation therapy were lower before treatment but were comparable to those of non-androgen deprivation therapy patients at 2 years post-treatment. We found that the impact of radiotherapy including proton beam therapy on urinary condition and sexual function was lower than that of surgery. Conclusions For the first time in Japan, we investigated health-related quality of life using Expanded Prostate Cancer Index Composite questionnaires in patients with prostate cancer after proton beam therapy and compared it with other treatment modalities.
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Affiliation(s)
- Kyoko Matsukawa
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan.,Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - Takeshi Arimura
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - Makiko Orita
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan
| | - Hisayoshi Kondo
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan
| | - Ikuko Chuman
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - Takashi Ogino
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - Yasuyuki Taira
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan
| | - Takashi Kudo
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Nagasaki University Graduate School of Biomedical Sciences, Atomic Bomb Disease Institute, Nagasaki, Japan
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Ngoo KS, Honda M, Kimura Y, Yumioka T, Iwamoto H, Morizane S, Hikita K, Takenaka A. Longitudinal study on the impact of urinary continence and sexual function on health-related quality of life among Japanese men after robot-assisted radical prostatectomy. Int J Med Robot 2019; 15:e2018. [PMID: 31115140 DOI: 10.1002/rcs.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/06/2019] [Accepted: 05/14/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study is to investigate the impact of robotic-assisted radical prostatectomy (RARP) on the health-related quality of life (HRQOL). METHODS We prospectively reviewed HRQOL parameters using Short-Form Health Survey, patient self-reporting of urinary incontinence and International Index of Erectile Function, among patients who underwent RARP between 2010 and 2016. RESULTS Among 249 men studied, all had significantly worse HRQOL domain scores at 1 month post operatively but 24 months after surgery, all domains reached or surpassed their baseline values. Only Bodily Pain, General Health, Role-Emotional, Mental Health domains, and Mental Health Composite were significantly improved. Improvement in urinary continence was mirrored by improvements in both Mental and Physical Component Scores. CONCLUSIONS Within a 2-year post-operative period, men who underwent RARP had regained their overall quality of life. The recovery of urinary continence significantly impacted the mental, physical, emotional, and social well-being of those patients.
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Affiliation(s)
- Kay Seong Ngoo
- Department of Urology, Hospital Angkatan Tentera Mizan, Kuala Lumpur, Malaysia
| | - Masashi Honda
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yusuke Kimura
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tetsuya Yumioka
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hideto Iwamoto
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Morizane
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Katsuya Hikita
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
| | - Atsushi Takenaka
- Department of Urology, Tottori University Faculty of Medicine, Yonago, Japan
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