BACKGROUND: Although younger men have better HRQOL scores after RP, many have higher baseline function with more to lose than older men.
We examined the impact of age on sexual and urinary function and bother (SF, UF, SB, UB) during the first 2 years after RP.
METHODS: Participants enrolled in CaPSURE reported sexual and urinary scores before and after RP using the UCLA PCI. Repeated measures mixed models compared HRQOLchange over time between younger (<=60) and older (>60) men. Logistic regression models assessed associations between age and clinically meaningful HRQOLdecline (worsening). Models were adjusted for clinical characteristics.
RESULTS: Among 1,806 patients, younger men reported higher SF and UF scores at each time point and higher rates of SF decline at 1 year than older men (81% versus 75%, p< 0.01). Younger men also had higher SB decline rates at 1 (74% versus 61%, p< 0.01) and 2 years (62% versus 56%, p=0.02) after RP. In multivariate analysis, age was associated withchanges in SF and SB from baseline through 2 years, both p< 0.01. Younger men had higher adjusted odds of SF decline at 1 year (OR 1.15 per 5 years, 95%CI 1.01-1.30, p=0.03) but not at 2 years. Younger age was associated with lower odds of worsening SB at 2 years (OR 0.79 per 5 years, 95%CI 0.67-0.94, p< 0.01). UF and UB decline rates were similar by age. Secondary analyses evaluating the age/HRQOL interaction showed that men were at greater risk of HRQOL declines if their baseline scores were above average, regardless of age.
CONCLUSION: Younger men reported higher SF and UF overall and experienced greater declines in SF immediately after RP than older men. While both groups experienced similar relative SF declines at 2 years, younger men had worse interim declines at 1 year. Providers should consider these findings when discussing the timing of treatment, particularly with younger men diagnosed with very early stage, low-grade disease.
Written by:
Brajtbord JS, Punnen S, Cowan JE, Welty CJ, Carroll PR. Are you the author?
Department of Urology and Helen Diller Family Comprehensive Cancer Center University of California, San Francisco.
Reference: J Urol. 2014 Feb 25. pii: S0022-5347(14)00300-0.
doi: 10.1016/j.juro.2014.02.045
PubMed Abstract
PMID: 24582539
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