Abstract
The objective of this study is to compare health-related quality of life (QOL) outcomes between radical prostatectomy (RP) and external beam radiation therapy (EBRT) for localized prostate cancer. PubMed, EMBASE, the Cochrane Library and Web of Science (to July 2017) were searched. Pooled analysis of each domain-specific score was calculated in relevant studies, and its change with follow-up time was explored by sub-group analysis. A total of six studies containing 4423 patients were included. Men underwent RP was associated with worse urinary and sexual domain score than EBRT (standardized mean difference (SMD) = –0.59, –0.58; 95% confidence interval (CI) = –0.73 to –0.45, –0.72 to –0.44). In contrast, EBRT group had lower bowel domain score than RP group (SMD = 0.42, 95% CI = 0.33 to 0.52). The sub-group analysis revealed the most severe urinary and sexual QOL in RP as well as bowel QOL in EBRT group all happened in the first month post operation. The different performance of two treatments in three QOL domains diminished afterwards. Health-related QOL should be considered comprehensively when planning follow-up for men after RP or EBRT for localized prostate cancer.
Highlights
Localized prostate cancer is classified by European Association of Urology (EAU) 2016 as in men with stage T1/T2, Nx/N0 and M0 [1] who are usually offered radical prostatectomy (RP), external beam radiation therapy (EBRT) and other treatments such as active surveillance, observation and brachytherapy
Randomized controlled trials (RCTs) [4,5,6,7], systematic reviews and meta-analysis [8,9,10] published so far have focused on clinical oncological outcomes such as overall and cancer-specific survival, with little attention to patient-reported outcomes like health-related quality of life (QOL). We conduct this systematic literature review and meta-analysis of QOL outcomes reported by men after RP and EBRT for localized prostate cancer to compare the difference in the extent and duration of impaired QOL between the two treatments
EBRT utilizes an external source of radiation to treat the prostate gland for men with localized prostate cancer
Summary
Localized prostate cancer is classified by European Association of Urology (EAU) 2016 as in men with stage T1/T2, Nx/N0 and M0 [1] who are usually offered radical prostatectomy (RP), external beam radiation therapy (EBRT) and other treatments such as active surveillance, observation and brachytherapy. Randomized controlled trials (RCTs) [4,5,6,7], systematic reviews and meta-analysis [8,9,10] published so far have focused on clinical oncological outcomes such as overall and cancer-specific survival, with little attention to patient-reported outcomes like health-related QOL. We conduct this systematic literature review and meta-analysis of QOL outcomes reported by men after RP and EBRT for localized prostate cancer to compare the difference in the extent and duration of impaired QOL between the two treatments
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