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Effect of perioperative complications and functional outcomes on health-related quality of life after radical prostatectomy

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Abstract

Purpose

Radical prostatectomy is a commonly performed procedure with perioperative complication rates of 30 % using standardized reporting methodology. We aim to determine whether perioperative complications and functional outcomes impact quality of life 1 year after surgical treatment.

Patients and methods

Quality of life, functional and oncological outcomes were assessed in patients who underwent open retropubic radical prostatectomy at a single academic institution between 2003 and 2009, preoperatively and 1 year after surgery using the EORTC QLQ-C30, the IIEF-5 and an institutional questionnaire. Perioperative complications were recorded using the Clavien–Dindo classification. Patients without complications were compared to patients with any, low- or high-grade complications. The global health score domain of the EORTC QLQ-C30 is reported for various oncological and functional outcomes and contrasted to stratified categories of complications and functional outcomes.

Results

A full dataset was available for 29.5 % (n = 856) of all patients. The overall complication rate was 27.5 % (235/856). A total of 307 complications were recorded of whom 88.9 % (273/307) were low grade. In this study, population global health perception did not decline after surgery (70.5 ± 21.2 vs. 74.4 ± 19.7; p < 0.0001). Complications showed only statistical but no clinical meaningful influence on global health perception as well as on functional and symptom scales. Patients who met combined outcome criteria experienced the best postoperative global health score (86.0 ± 13.1 and 86.0 ± 14.2).

Conclusions

Perioperative complications and functional outcomes have a measurable impact on quality of life 1 year following surgery. While perioperative complications have a statistical effect, functional outcomes showed a clinically more profound effect on postoperative global health perception.

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References

  1. Eastham, J. A., Scardino, P. T., & Kattan, M. W. (2008). Predicting an optimal outcome after radical prostatectomy: The trifecta nomogram. The Journal of Urology, 179(6), 2207–2210. (discussion 2210-220).

    Article  PubMed  Google Scholar 

  2. Patel, V. R., Sivaraman, A., Coelho, R. F., Chauhan, S., Palmer, K. J., Orvieto, M. A., et al. (2011). Pentafecta: A new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy. European Urology, 59(5), 702–707.

    Article  PubMed  Google Scholar 

  3. Treiyer, A., Anheuser, P., Butow, Z., & Steffens, J. (2011). A single center prospective study: Prediction of postoperative general quality of life, potency and continence after radical retropubic prostatectomy. The Journal of Urology, 185(5), 1681–1685.

    Article  PubMed  Google Scholar 

  4. Perl, M., Waldmann, A., Pritzkuleit, R., & Katalinic, A. (2012). Temporal changes in quality of life after prostate carcinoma. Der Urologe Ausg A, 51(5), 706–712.

    Article  CAS  PubMed  Google Scholar 

  5. Viklund, P., Lindblad, M., & Lagergren, J. (2005). Influence of surgery-related factors on quality of life after esophageal or cardia cancer resection. World Journal of Surgery, 29(7), 841–848.

    Article  PubMed  Google Scholar 

  6. Dindo, D., Demartines, N., & Clavien, P.-A. (2004). Classification of surgical complications. Annals of Surgery, 240(2), 205–213.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Novara, G., Ficarra, V., D’Elia, C., Secco, S., Cavalleri, S., & Artibani, W. (2010). Prospective evaluation with standardised criteria for postoperative complications after robotic-assisted laparoscopic radical prostatectomy. European Urology, 57(3), 363–370.

    Article  PubMed  Google Scholar 

  8. Hruza, M., Weiss, H. O., Pini, G., Goezen, A. S., Schulze, M., Teber, D., et al. (2010). Complications in 2200 consecutive laparoscopic radical prostatectomies: Standardised evaluation and analysis of learning curves. European Urology, 58(5), 733–741.

    Article  PubMed  Google Scholar 

  9. Rabbani, F., Yunis, L. H., Pinochet, R., Nogueira, L., Vora, K. C., Eastham, J. A., et al. (2010). Comprehensive standardized report of complications of retropubic and laparoscopic radical prostatectomy. European Urology, 57(3), 371–386.

    Article  PubMed  Google Scholar 

  10. Walsh, P. C., & Donker, P. J. (1982). Impotence following radical prostatectomy: Insight into etiology and prevention. The Journal of Urology, 128(3), 492–497.

    CAS  PubMed  Google Scholar 

  11. Graefen, M., Michl, U. H. G., Heinzer, H., Friedrich, M. G., Eichelberg, C., Haese, A., et al. (2005). Indication, technique and outcome of retropubic nerve-sparing radical prostatectomy. EAU Update Series, 3(2), 77–85.

    Article  Google Scholar 

  12. Rhoden, E. L., Teloken, C., Sogari, P. R., & Vargas Souto, C. A. (2002). The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. International Journal of Impotence Research, 14(4), 245–250.

    Article  CAS  PubMed  Google Scholar 

  13. Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376.

    Article  CAS  PubMed  Google Scholar 

  14. Osoba, D., Rodrigues, G., Myles, J., Zee, B., & Pater, J. (1998). Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology, 16(1), 139–144.

    CAS  PubMed  Google Scholar 

  15. Cocks, K., King, M. T., Velikova, G., de Castro, G., St-James, M. M., Jr, Fayers, P. M., et al. (2012). Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. European Journal of Cancer, 48(11), 1713–1721.

    Article  CAS  PubMed  Google Scholar 

  16. Fayers, P. M., Aaronson, N. K., Bjordal, K., Groenvold, M., Curran, D., Bottomley, A., et al. (2001). The EORTC QLQ-C30 scoring manual (3rd ed.). Brussels: European Organisation for Research and Treatment of Cancer.

  17. Mann, H. B., & Whitney, D. R. (1947). On a test of whether one of two random variables is stochastically larger than the other. Annals of Mathematical Statistics, 18(1), 50–60.

    Article  Google Scholar 

  18. Wilcoxon, F. (1945). Individual comparisons by ranking methods. Biometrics Bulletin, 1(6), 80–83.

    Article  Google Scholar 

  19. Pearson, K. (1900). On the criterion that a given system of deviations from the probable in the case of a correlated system of variables is such that it can be reasonably supposed to have arisen from random sampling. The London, Edinburgh, and Dublin Philosophical Magazine and Journal of Science, 50(302), 157–175.

    Article  Google Scholar 

  20. Loppenberg, B., Noldus, J., Holz, A., & Palisaar, R. J. (2010). Reporting complications after open radical retropubic prostatectomy using the Martin criteria. The Journal of Urology, 184(3), 944–948.

    Article  PubMed  Google Scholar 

  21. Schwarz, R., & Hinz, A. (2001). Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. European Journal of Cancer, 37(11), 1345–1351.

    Article  CAS  PubMed  Google Scholar 

  22. Scott, N. W., Fayers, P. M., Aaronson, N. K., Bottomley, A., de Graeff, A., Groenvold, M., et al. (2008). EORTC QLQ-C30 reference values. Brussels: EORTC Quality of Life Group.

    Google Scholar 

  23. Hjermstad, M. J., Fayers, P. M., Bjordal, K., & Kaasa, S. (1998). Using reference data on quality of life—The importance of adjusting for age and gender, exemplified by the EORTC QLQ-C30 (+3). European Journal of Cancer, 34(9), 1381–1389.

    Article  CAS  PubMed  Google Scholar 

  24. Waldmann, A., Schubert, D., & Katalinic, A. (2013). Normative data of the EORTC QLQ-C30 for the German population: A population-based survey. PLoS ONE, 8(9), e74149.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. King, M. T. (1996). The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research, 5(6), 555–567.

    Article  CAS  PubMed  Google Scholar 

  26. Augustin, H., Pummer, K., Daghofer, F., Habermann, H., Primus, G., & Hubmer, G. (2002). Patient self-reporting questionnaire on urological morbidity and bother after radical retropubic prostatectomy. European Urology, 42(2), 112–117.

    Article  PubMed  Google Scholar 

  27. Giberti, C., Chiono, L., Gallo, F., Schenone, M., & Gastaldi, E. (2009). Radical retropubic prostatectomy versus brachytherapy for low-risk prostatic cancer: A prospective study. World Journal of Urology, 27(5), 607–612.

    Article  CAS  PubMed  Google Scholar 

  28. Barry, M. J., Gallagher, P. M., Skinner, J. S., & Fowler, F. J., Jr. (2012). Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of medicare-age men. Journal of Clinical Oncology, 30(5), 513–518.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Malcolm, J. B., Fabrizio, M. D., Barone, B. B., Given, R. W., Lance, R. S., Lynch, D. F., et al. (2010). Quality of life after open or robotic prostatectomy, cryoablation or brachytherapy for localized prostate cancer. The Journal of Urology, 183(5), 1822–1828.

    Article  PubMed  Google Scholar 

  30. Soderdahl, D. W., Davis, J. W., Schellhammer, P. F., Given, R. W., Lynch, D. F., Shaves, M., et al. (2005). Prospective longitudinal comparative study of health-related quality of life in patients undergoing invasive treatments for localized prostate cancer. Journal of Endourology, 19(3), 318–326.

    Article  PubMed  Google Scholar 

  31. Agarwal, P. K., Sammon, J., Bhandari, A., Dabaja, A., Diaz, M., Dusik-Fenton, S., et al. (2011). Safety profile of robot-assisted radical prostatectomy: A standardized report of complications in 3317 patients. European Urology, 59(5), 684–698.

    Article  PubMed  Google Scholar 

  32. Sprangers, M. A., & Schwartz, C. E. (1999). The challenge of response shift for quality-of-life-based clinical oncology research. Annals of Oncology, 10(7), 747–749.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Björn Löppenberg.

Appendix: Questionnaire for patients after open retropubic radical prostatectomy

Appendix: Questionnaire for patients after open retropubic radical prostatectomy

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Löppenberg, B., von Bodman, C., Brock, M. et al. Effect of perioperative complications and functional outcomes on health-related quality of life after radical prostatectomy. Qual Life Res 23, 2743–2756 (2014). https://doi.org/10.1007/s11136-014-0729-1

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