OBJECTIVE: To improve and individualize estimates of treatment outcomes for men diagnosed with prostate cancer, we examined the impact of baseline comorbidity on these health-related quality of life (HRQOL) outcomes in an analysis of two pooled, prospective cohort studies.
PATIENTS AND METHODS: We studied 697 patients from 3 academic hospitals who received radical prostatectomy, external beam radiation, or brachytherapy. Measures of patient-reported bowel, urinary, and sexual symptoms along with physical and mental health were prospectively collected at pretreatment and 3, 12, 24, and 36- months after diagnosis. We assessed baseline comorbidity by the validated Index of Co-Existent Disease (ICED), abstracted from medical records. Regression mixed-models were built for each treatment group and HRQOL outcome controlling for baseline age, education, marital status, risk group and patient-reported general health.
RESULTS: Approximately 71% of patients had one or more comorbid conditions at baseline. After adjusting for covariates, we found baseline comorbidity was independently associated with poorer sexual function after brachytherapy (p=0.04) and radical prostatectomy (p=0.03) but not external beam radiation (p=0.35). Physical health was significantly worse for men receiving brachytherapy with greater comorbidities (p=0.02). Baseline comorbid conditions were not associated with urinary incontinence or bowel functioning.
CONCLUSIONS: Comorbidity at baseline is significantly associated with poorer sexual function after prostate brachytherapy or prostatectomy. This information may help patients and their physicians anticipate outcomes after surgical and radiation treatments.
Written by:
Reeve BB, Chen RC, Moore DT, Deal Ms AM, Usinger DS, Lyons JC, Talcott JA. Are you the author?
Lineberger Comprehensive Cancer Center; Department of Health Policy & Management, Gillings School of Global Public Health.
Reference: BJU Int. 2014 Mar 3. Epub ahead of print.
doi: 10.1111/bju.12723
PubMed Abstract
PMID: 24588845
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