Objectives: To investigate the quality of life (QoL) after different treatment modalities of low risk prostate cancer, including brachytherapy, robot assisted laparoscopic prostatectomy (RALP), and active surveillance (AS) with validated questionnaires.
Material and Methods: From a prospective database we selected a total of 144 men with low-grade localized prostate cancer including 65 (45.1%) patients with RALP, 29 (20.2%) with brachytherapy, and 50 (34.7%) managed with AS. QoL was routinely evaluated with validated questionnaires (EORTC-QLQ-C30, EORTC-QLQ-PR25, IIEF-15, ICIQ-SF) with a minimum follow-up of one year.
Results: In comparison to baseline scores, the brachytherapy group showed a significant decrease of QoL domain scores of voiding complaints (p=0.010), use of incontinence aids (p=0.011), sexual functioning domain(p=0.011), and erectile function (p≤=0.001). In the RALP group, sexual function (p≤=0.001), incontinence (p≤=0.001), and erectile function were significantly affected. A decrease in sexual function was observed in 71% of men after RALP and 59% after brachytherapy. In 30% of men under AS, a decrease of erectile function score during follow-up was reported. Overall, no significant decrease in general QoL was observed neither for men under AS, nor for men treated by brachytherapy or RALP. Clinical factors such as age, prostate size, PSA and nerve-preservation during RALP were non-predictive of overall-QoL after treatment for the individual patient (p=0.676).
Conclusion: Patients with low risk prostate cancer who are treated with brachytherapy or RALP report deterioration of quality of life of specific domains such as voiding, continence, and sexual functioning in comparison of AS patients. A decrease of erectile function was also observed during AS. Overall QoL was similar for all three treatments options.
Written by:
Acar C, Schoffelmeer C, Tillier C, de Blok W, van Muilekom E, van der Poel H. Are you the author?
Acibadem University School of Medicine, Urology, Istanbul, Netherlands.
Reference: J Endourol. 2013 Aug 26. Epub ahead of print.
doi: 10.1089/end.2013.0349
PubMed Abstract
PMID: 23978277
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