MP15-06 HEALTH-RELATED QUALITY OF LIFE IN ROBOTIC VERSUS OPEN RADICAL PROSTATECTOMY: FIRST REPORT

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2014MP15-06 HEALTH-RELATED QUALITY OF LIFE IN ROBOTIC VERSUS OPEN RADICAL PROSTATECTOMY: FIRST REPORT Stacy Rush, Shabbir M.H. Alibhai, Lizhen Xu, Wei Xu, Alyssa S. Louis, Andrew G. Matthew, Michael Nesbitt, Antonio Finelli, Neil E. Fleshner, Robert Hamilton, Girish Kulkarni, Alexandre Zlotta, Michael AS. Jewett, and John Trachtenberg Stacy RushStacy Rush More articles by this author , Shabbir M.H. AlibhaiShabbir M.H. Alibhai More articles by this author , Lizhen XuLizhen Xu More articles by this author , Wei XuWei Xu More articles by this author , Alyssa S. LouisAlyssa S. Louis More articles by this author , Andrew G. MatthewAndrew G. Matthew More articles by this author , Michael NesbittMichael Nesbitt More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Neil E. FleshnerNeil E. Fleshner More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Girish KulkarniGirish Kulkarni More articles by this author , Alexandre ZlottaAlexandre Zlotta More articles by this author , Michael AS. JewettMichael AS. Jewett More articles by this author , and John TrachtenbergJohn Trachtenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.559AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite growing use of robot-assisted laparoscopic radical prostatectomy (RARP), it is unclear if health-related quality of life (HRQoL) outcomes are superior to open prostatectomy (ORP). METHODS We retrospectively analyzed records from men who received ORP or RARP at our institution as their primary therapy for prostate cancer between January 2009 and December 2012. Patients completed a demographics questionnaire and the Patient-Oriented Prostate Utility Scale (PORPUS), a validated disease-specific HRQoL instrument prior to surgery and every 3 months up to 15 months after surgery. RESULTS A total of 974 men met the inclusion criteria, 643 ORP and 331 RARP patients. At baseline, RARP patients were significantly younger (p<0.001), had lower body mass index (p<0.001), lower pre-operative prostate-specific antigen (PSA) (p<0.001), fewer comorbidities (p<0.004) and higher baseline PORPUS scores (p=0.024). On follow-up, unadjusted PORPUS scores were significantly higher in the RARP group at each point. However, on multivariable analysis adjusting for age, type of procedure (ORP vs. RARP), Gleason score, BMI, first PSA, comorbidity, ethnicity, and baseline PORPUS scores, PORPUS score was higher for the RARP group at 3 months (p=0.031) and 9 months (p=0.002), but not at 6, 12 or 15 months. No difference was greater than the minimum clinically significant difference. CONCLUSIONS Though HRQoL outcomes appear improved with RARP, these differences are not clinically important and are likely accounted for by baseline differences in patient selection. Further comparative studies and randomized trials are needed to assess whether one treatment option provides consistently better HRQOL outcomes. Table 1. Baseline demographics of study patients Factors Open Robotic p-value Age (Years) N 643 331 Mean (sd) 61.49(7.07) 59.71(7.03) <0.001 First Elevated PSA N 432 195 Mean (sd) 7.58 (5.22) 5.89 (3.28) <0.001 BMI N 597 299 Mean (sd) 28.6 (4.0) 27.3 (3.6) <0.001 Charlson comorbidity score 0 512 (80) 289 (87) > = 1 131 (20) 42 (13) 0.004 Biopsy Gleason Score N (%) Low/Intermediate risk: Gleason 4, 5, 6, or 7 532 (88) 310 (99) High risk: Gleason 8, 9, 10 76 (12) 4 (1) <0.001 Ethnicity Caucasian: n(%) 228 (75) 98 (63) Non Caucasian n(%) 75 (25) 58 (37) 0.008 PORPUS-P Score N 437 210 Mean (sd) 82.59(11.10) 84.73(11.26) 0.024 Nerve Sparing Status None: n (%) 155 (25) 19 (7) Unilateral: n (%) 146 (23) 45 (15) Bilateral: n (%) 326 (52) 224 (78) <0.001 Data are shown only for statistically significantly different characteristics. Table 2. Univariate predictors of baseline (pre-operative) PORPUS-P Variable Effect Confidence Interval p-value Age -0.22 (-0.34,-0.105) <0.001 Type of RP∗ 2.14 (0.30,3.98) 0.023 Gleason Score -4.35 (-7.33,-1.37) 0.004 BMI -0.025 (-0.26,0.21) 0.836 First Positive PSA -0.24 (-0.44, -0.04) 0.017 ∗ RARP compared to ORP © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e146-e147 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Stacy Rush More articles by this author Shabbir M.H. Alibhai More articles by this author Lizhen Xu More articles by this author Wei Xu More articles by this author Alyssa S. Louis More articles by this author Andrew G. Matthew More articles by this author Michael Nesbitt More articles by this author Antonio Finelli More articles by this author Neil E. Fleshner More articles by this author Robert Hamilton More articles by this author Girish Kulkarni More articles by this author Alexandre Zlotta More articles by this author Michael AS. Jewett More articles by this author John Trachtenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...