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Health-related quality of life following radical prostatectomy: long-term outcomes

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Abstract

Purpose

To identify the health-related quality of life (HRQoL) domains that radical prostatectomy (RP) impacts most negatively and to define the recovery of these domains over 30 months of observation.

Patients and methods

A total of 1,200 RP patients completed the Patient-Oriented Prostate Utility Scale-Psychometric (PORPUS-P; range 0–100, higher is better), a prostate cancer-specific HRQoL measure, prior to RP and at 0–3 (T1), 3–9 (T2), 9–18 (T3) and 18–30 (T4) months post-RP. HRQoL changes were examined using paired t tests and a mixed-effect growth curve model. Multivariable analyses were performed to investigate demographic and treatment factors predicting the change in HRQoL.

Results

Mean baseline PORPUS-P score, 83.1, fell to 66.5 (p < 0.001) at T1. Over time HRQoL improved but did not return to baseline (T4 mean 76.4, p < 0.001). Domain analysis revealed that sexual function (p < 0.001), sexual drive (p < 0.001), energy (p = 0.001) and bladder control (p < 0.001) failed to return to baseline at T4. Sexual function demonstrated the greatest impairment overall. The multivariable model revealed Black men experienced greater losses in global HRQoL compared with White men (coefficient −2.77, 95 % CI −5.00 to −0.54, p = 0.015). High baseline HRQoL, pro-erectile aid use and bilateral nerve-sparing were significantly associated with smaller reductions in HRQoL post-RP.

Conclusion

Overall HRQoL, sexual drive, sexual function, energy and bladder control do not return to preoperative levels within 30 months post-RP. Black patients experience the greatest reductions in HRQoL. HRQoL losses may be ameliorated by use of pro-erectile aids. These findings help to identify at-risk patient populations and inform survivorship programs.

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Acknowledgments

This study was generously supported by Jack and Anne Weinbaum and Family.

Conflict of interest

This study was supported by Jack and Anne Weinbaum and Family.

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Authors and Affiliations

  1. Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Andrew G. Matthew, Tal Davidson, Kristen L. Currie, Neil E. Fleshner, Alyssa S. Louis & John Trachtenberg

  2. Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Andrew G. Matthew

  3. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Andrew G. Matthew, Shabbir M. H. Alibhai, Murray Krahn, Neil E. Fleshner & John Trachtenberg

  4. General Internal Medicine and Geriatrics, University Health Network, Toronto, ON, Canada

    Shabbir M. H. Alibhai

  5. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Shabbir M. H. Alibhai

  6. Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Haiyan Jiang

  7. Toronto Health Economics and Technology Assessment Collaborative, Toronto, ON, Canada

    Murray Krahn

  8. Department of Medicine, University Health Network, Toronto, ON, Canada

    Murray Krahn

  9. Meridian Software, Toronto, ON, Canada

    Robin Kalnin

  10. College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada

    B. Joyce Davison

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  1. Andrew G. Matthew
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Correspondence to Andrew G. Matthew.

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Matthew, A.G., Alibhai, S.M.H., Davidson, T. et al. Health-related quality of life following radical prostatectomy: long-term outcomes. Qual Life Res 23, 2309–2317 (2014). https://doi.org/10.1007/s11136-014-0664-1

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