1470 INFLUENCE OF COMPLICATIONS ON HEALTH-RELATED QUALITY OF LIFE AFTER OPEN RETROPUBIC RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111470 INFLUENCE OF COMPLICATIONS ON HEALTH-RELATED QUALITY OF LIFE AFTER OPEN RETROPUBIC RADICAL PROSTATECTOMY Björn Löppenberg, Christian von Bodman, Florian Roghmann, Alexander Holz, Jüri Palisaar, and Joachim Noldus Björn LöppenbergBjörn Löppenberg Herne, Germany More articles by this author , Christian von BodmanChristian von Bodman Herne, Germany More articles by this author , Florian RoghmannFlorian Roghmann Herne, Germany More articles by this author , Alexander HolzAlexander Holz Herne, Germany More articles by this author , Jüri PalisaarJüri Palisaar Herne, Germany More articles by this author , and Joachim NoldusJoachim Noldus Herne, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1405AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Standardized assessment of complications following open retropubic prostatectomy (ORRP) results in overall complication rates of about 30%. To our knowledge the influence of complications on health-related quality of life (HRQOL) has not been investigated yet. Objective was to evaluate the influence of complications on HRQOL one year after ORRP. METHODS Medical and surgical complications of ORRP were assessed prospectively within 30 days postoperative. They were graded according to the Clavien-Dindo classification retrospectively. HRQOL was assessed preoperatively and one year after ORRP using the EORTC-QLQ C30 questionnaire. Pre- and postoperative results were compared by using the Wilcoxon rank test. HRQOL of patients without complications were compared to patients who had complications using the Mann Whitney-U test. A p<0.05 was considered statistically significant. RESULTS Between August 2003 and May 2010 3173 patients underwent ORRP for clinically localized prostate cancer in a single institution. Return rate of the questionnaire was 64.8% (n=2057). All of these patients were enrolled in the analysis. Overall complication rate was 26.8% (n=552). Low-grade (Clavien-Dindo 1–2) or high-grade (Clavien-Dindo 3-5) complications occurred in 24.1% (n=496) and 5.0% (n=103), respectively. Results of pre- and postoperative HRQOL are shown in table 1. In general several symptom scales and all function scales of QLQC30 worsen one year after ORRP. The subjective global health status improves significantly after ORRP. Overall-complications or low-grade complications influence several symptom- and functional scales significantly. The Global health status of patients who had a low grade complication in comparison to patients who had no complication is worse. High-grade complications did not influence any of the symptom or functional scales. Global health status of patients with high-grade complications did not differ from patients without complications. Influence of complications on health related quality of life EORTC QLQ 30 items preoperative values (mean >SD) postoperative values (mean >SD) pre vs. postoperative (Wilcoxon Rank test) no complication any complication any vs. no complication (Mann-Whitney-U Test) low-grade low-grade vs. no complications (Mann-Whitney- U Test) high-grade high-grade vs. no complications (Mann-Whitney-U Test) whole cohort whole cohort p p p p Symptom scalesa dyspnoea 9.8>21.0 14.4 >25.1 >0.0001 13.3>22.4 17.2>26.6 0.001 17.3>26.6 0.001 16.2>24.6 0.223 insomnia 19.1>27.5 20.8>28.5 0.119 20.7>28.4 21.1>28.8 0.834 21.1>28.8 0.822 22.3>29.0 0.524 appetite loss 4.1>14.7 3.4>12.8 0.064 2.9>1.9 4.5>14.9 0.035 4.4>15.0 0.063 5.2>15.3 0.126 nausea & vomiting 1.3>6.8 1.6>7.3 0.161 1.4>6.4 2.1>9.5 0.849 2.0>9.1 0.763 2.4>11.5 0.840 constipation 3.7>13.2 8.1>20.3 >0.0001 7.5>19.4 9.7>22.5 0.045 9.9>23.2 0.117 8.8>16.9 0.081 diarrhea 6.3>16.4 6.5>17.0 0.819 5.9>15.8 8.1>19.7 0.035 8.5>20.4 0.022 5.6>15.0 0.835 fatigue 14.1>19.0 19.2>22.1 >0.0001 18.4>21.5 21.2>23.6 0.033 22.0>24.0 0.004 17.3>20.3 0.424 pain 10.9>21.9 10.2>20.5 0.416 9.6>20.2 11.3>21.3 0.083 11.8>21.8 0.026 9.2>18.2 0.988 Function scalesb physical functioning 95.5>9.9 90.2>14.9 >0.0001 91.3>13.7 87.1>17.5 >0.0001 86.6>17.7 >0.0001 89.2>16.1 0.963 role functioning 90.9>19.1 84.9>23.3 >0.0001 85.9>22.4 81.9>25.4 0.452 82.0>25.4 0.004 81.7>25.3 0.180 emotional functioning 70.9>24.9 78.2>23.2 >0.0001 78.6>22.9 77.2>24.0 0.002 77.0>24.1 0.263 78.0>24.1 0.794 cognitive functioning 87.4>18.6 85.8>20.1 0.024 86.1>19.7 85.2>20.9 0.452 85.2>21.0 0.511 83.8>23.0 0.644 social functioning 84.8>21.4 79.6>25.3 >0.0001 80.7>24.5 76.6>27.0 0.003 77.2>26.2 0.012 75.2>29.5 0.199 global health status 70.5>21.2 73.9>19.8 >0.0001 74.7>19.5 71.5>20.5 >0.0001 71.5>20.3 0.001 72.3>22.6 0.694 * SD standard deviation a low values represent low symptom intensity b high values represent a good function CONCLUSIONS Global health status improves after ORRP. Complications have a significant impact on postoperative HRQOL. However, high-grade complications do not have influence on symptom scales, functional scales and global health status. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e589 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Björn Löppenberg Herne, Germany More articles by this author Christian von Bodman Herne, Germany More articles by this author Florian Roghmann Herne, Germany More articles by this author Alexander Holz Herne, Germany More articles by this author Jüri Palisaar Herne, Germany More articles by this author Joachim Noldus Herne, Germany More articles by this author Expand All Advertisement Advertisement Loading ...