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Analysis of quality of life and late biochemical predictors for localized cancer recurrence following radical prostatectomy

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Abstract

Background

Patients with localized prostate cancer (PCa) experience biochemical recurrence (BCR) despite a curatively intended radical prostatectomy (RP). The aim of this study was to describe the quality of life (QoL) of patients with a BCR while identifying predictors of early (ER) and late recurrence (LR).

Methods

For this purpose, a total of 330 PCa patients with a BCR following RP at Charité University Hospital in Berlin were analyzed. BCR was defined as two consecutive PSA values ≥ 0.2 after a previous non-detectable level. LR was defined as a BCR after 3 years post-RP. Differences in overall survival (OS) were calculated using the log-rank testing. A logistic regression model was applied to identify predictors of ER and LR. We further evaluated difference between ER and LR with respect to functional outcomes in urinary and sexual domains as well as the patients QoL.

Results

Out of 330 patients, 180 patients showed late BCR. Patients rated their global QoL with 64.5% in ER and 68.8% LR as good (EORTC quality of life Questionnaire, question 29 and 30). The questionnaire did not reveal QoL differences in terms of sexual and urinary function within ER and LR. The main predictor for LR was preoperative serum prostate-specific antigen (PSA) levels with a relative risk (RR) of 0.96 (p = 0.011). OS for patients with LR was significant longer than for patients with ER (154.3 vs. 143.2 months, p = 0.018).

Conclusion

Patients with a BCR show a good quality of life possibly irrespective of the time point of BCR. We further identified preoperative PSA levels as a predictor of LR and noted that patients with LR patients lived longer. Further studies are needed.

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Abbreviations

ADT:

Androgen deprivation therapy

BCR:

Biochemical recurrence

CSM:

Cancer-specific mortality

ER:

Early recurrence

LR:

Late recurrence

LRP:

Laparoscopic radical prostatectomy

OS:

Overall survival

PCa:

Prostate cancer

PCSM:

Prostate cancer-specific survival

PLND:

Pelvic lymph node dissection

PSA:

Prostate-specific antigen

PSADT:

PSA doubling time

PSM:

Positive surgical margin

QoL:

Quality of life

RP:

Radical prostatectomy

RR:

Relative risk

SRT:

Salvage radiation therapy

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Acknowledgements

We acknowledge the excellent work of Markus Loos on the Charité prostate cancer database.

Funding

The authors received no funding for this work.

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Authors

Contributions

Conceptualization: JB and AM; data curation: LA; writing: FF and LB; supervision: KM, AM and SH; review and editing: NS and AB.

Corresponding author

Correspondence to Frank Friedersdorff.

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The authors declare that they have no conflict of interest.

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The study involved human participants, but no animals.

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We received the written informed consent from all the patients.

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Friedersdorff, F., Buckendahl, L., Alt, L. et al. Analysis of quality of life and late biochemical predictors for localized cancer recurrence following radical prostatectomy. World J Urol 38, 1501–1507 (2020). https://doi.org/10.1007/s00345-019-02921-5

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  • DOI: https://doi.org/10.1007/s00345-019-02921-5

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