Dynamic Changes of Generic Quality of Life after Different Treatments for Localized Prostate Cancer.

Yao-Lin Kao,Sheng-Hsiang Lin,Yuh-Shyan Tsai,Jung-Der Wang,Chien-Hui Ou,Sheng-Mao Chang

doi:10.3390/jcm10010158

Abstract

Generic quality of life (QoL) is an important issue in decision making related to the primary treatment of localized prostate cancer (PC). This study assessed the dynamic changes of QoL in patients with localized PC under different treatment modalities. From 2013 to 2018, we prospectively assessed QoL scores in patients with localized PC under unitary treatment using the World Health Organization Quality of Life (WHOQOL) BREF version. The trajectories of the QoL scores after different treatments were estimated using a kernel-smoothing method. Dynamic changes in the major determinants were analyzed using a mixed effects model. The clinical features of the participants in our institute were compared with PC patients in Taiwan’s cancer registry. A total of 196 patients were enrolled with 491 repeated assessments. The participants shared similar clinical characteristics with the PC patients in Taiwan as a whole. Patients with lower household incomes showed statistically significant lower scores on all four domains and related facets, while PC survivors with comorbidities of anxiety and/or diabetes appeared to be affected on the physical domain and related facets. After controlling for these determinants, patients under active surveillance or observation demonstrated significantly higher QoL scores in the physical and social domains, as well as several facets belonging to these domains, in mixed models compared with patients undergoing radical prostatectomy or radiotherapy within the first year. The generic QoL scores were higher within the first year in patients receiving active surveillance or observation after controlling other significant factors. The difference diminished after one year of post management. More studies are needed to corroborate our findings.

Highlights

Prostate cancer (PC) is the most common non-cutaneous male malignancy in developed countries [1]
A total of 196 patients with localized prostate cancer (PC) receiving standard cancer management were enrolled in the outpatient department of urology at National Cheng Kung University
We found that family income had positive impacts on the scores of all four domains of the World Health Organization Quality of Life (WHOQOL)-BREF and on many of the facets

Summary

Introduction

Prostate cancer (PC) is the most common non-cutaneous male malignancy in developed countries [1]. Current clinical guidelines recommend that patients with localized PC receive management including radical prostatectomy (RP), external beam radiotherapy (RT), or active surveillance (AS) [3]. While these management techniques have comparable cancer-specific survival rates based on long-term follow-up [4], each treatment has unique side effects for PC survivors, such as urinary incontinence in RP, bowel function in RT, and anxiety in AS [5,6]. Previous studies have often failed to identify the differences in generic QoL among different primary management options [9]. We aim toward assessing the differences in generic

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Discussion

Conclusion