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Quality of Life in Men With Locally Advanced Adenocarcinoma of the Prostate: An Exploratory Analysis Using Data From the CaPSURE Database

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2008.08.079

1527-3792

Wesley M. White, Natalia Sadetsky, W. Bedford Waters, Peter R. Carroll, Mark S. Litwin,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyAdult Urology1 Dec 2008Quality of Life in Men With Locally Advanced Adenocarcinoma of the Prostate: An Exploratory Analysis Using Data From the CaPSURE Database Wesley M. White, Natalia Sadetsky, W. Bedford Waters, Peter R. Carroll, and Mark S. Litwin Wesley M. WhiteWesley M. White Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee , Natalia SadetskyNatalia Sadetsky Department of Urology, University of California-San Francisco, San Francisco, California , W. Bedford WatersW. Bedford Waters Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee , Peter R. CarrollPeter R. Carroll Department of Urology, University of California-San Francisco, San Francisco, California , and Mark S. LitwinMark S. Litwin Department of Urology, University of California-Los Angeles, Los Angeles, California View All Author Informationhttps://doi.org/10.1016/j.juro.2008.08.079AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present longitudinal quality of life outcomes in a national observational cohort of men with locally advanced prostate adenocarcinoma. Materials and Methods: The CaPSURE® registry was used to evaluate quality of life in men with clinical T3 or T4 prostate adenocarcinoma who underwent primary treatment and had a minimum followup of 2 years. Records were reviewed for treatment, patient age, T stage, prostate specific antigen at diagnosis, body mass index, and initial and posttreatment quality of life using the SF-36® and UCLA-PCI questionnaires, which can each be scored from 0 to 100 with higher scores indicating better outcomes. The association of treatment type and quality of life changes after treatment were evaluated with multivariate mixed model analysis, adjusting for age, time of quality of life assessment, and interaction between treatment and time. Results: Of the 13,740 men enrolled in CaPSURE 608 (4.42%) presented with T3 or T4 tumors. In this subgroup 151 men completed baseline and a minimum of 2 years of followup with quality of life data available. These men underwent primary treatment with radical prostatectomy (21%), cryotherapy (8%), brachytherapy (17%) or hormonal ablation (54%). The treatment cohort demonstrated significant decreases in quality of life, most profoundly in urinary and sexual function. Mean urinary function was 91 at baseline, which decreased to 82, 83 and 82 at 1, 2 and 3 years after treatment, respectively (p = 0.04). Mean sexual function was 38 at baseline, which decreased to 15, 16 and 14 at 1, 2 and 3 years after treatment, respectively (p <0.01). On multivariate analysis quality of life varied significantly by treatment type (p <0.01). Conclusions: Treatment for locally advanced prostate adenocarcinoma is associated with a significant burden in patients, notably decrements in urinary and sexual function. Clinicians should consider the impact that treatment imparts on quality of life when counseling patients with locally advanced disease. References 1 Cancer Facts and Figures 2008. Atlanta: American Cancer Society2008. Google Scholar 2 : Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA1993; 270: 948. Crossref, Medline, Google Scholar 3 : Declining rates of extracapsular extension after radical prostatectomy: evidence for continued stage migration. J Clin Oncol1999; 17: 3167. Google Scholar 4 : Treatment of locally advanced prostate cancer. In: . Edited by . Philadelphia: WB Saunders2007: 3053. chapt 102. Google Scholar 5 : Radical prostatectomy: long-term cancer control and recovery of sexual and urinary function ("trifecta"). Urology2005; 66: 83. Google Scholar 6 : The CaPSURE database: a methodology for clinical practice and research in prostate cancer. CaPSURE Research Panel. Cancer of the Prostate Strategic Urologic Research Endeavor Urology. Urology1996; 48: 773. Google Scholar 7 : Radiation therapy for prostate cancer. In: . Edited by . Philadelphia: WB Saunders2007: 3006. chapt 100. Google Scholar 8 : Impotence following radical prostatectomy: Insight into etiology and prevention. J Urol1982; 128: 492. Link, Google Scholar 9 : Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology2000; 55: 58. Google Scholar 10 : Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer2007; 109: 2239. Google Scholar 11 : Health related quality of life in men with prostate cancer. J Urol2003; 169: 1653. Link, Google Scholar 12 : Changes in health-related quality of life in the first year after treatment for prostate cancer: results from CaPSURE. Urology1999; 53: 1999. Google Scholar 13 : Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality-of-life analysis from CaPSURE: Cancer of the Prostate Strategic Urologic Research Endeavor. Urology1999; 54: 503. Google Scholar 14 : Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med2008; 358: 1250. Google Scholar 15 : The quality of life of men with locally advanced prostate cancer during neoadjuvant hormone therapy: data from the Medical Research Council RT01 trial (ISRCTN 47772397). BJU Int2007; 99: 301. Google Scholar 16 : Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience. J Urol2003; 170: 1126. Link, Google Scholar 17 : Cryotherapy for prostate cancer. In: . Edited by . Philadelphia: WB Saunders2007: 3032. chapt 101. Google Scholar 18 : Extended experience with radical prostatectomy for clinical stage T3 prostate cancer: outcome and contemporary morbidity. J Urol1995; 154: 1447. Link, Google Scholar 19 : Intermediate-term potency, continence, and survival outcomes of radical prostatectomy for clinically high-risk or locally advanced prostate cancer. Urology2007; 69: 1170. Google Scholar 20 : The efficacy and complications of salvage cryotherapy of the prostate. J Urol1997; 157: 921. Link, Google Scholar 21 : Epidemiology and pathophysiology of prostate cancer in African-American men. J Urol2007; 177: 444. Link, Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetails Volume 180Issue 6December 2008Page: 2409-2414 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsprostatequestionnairescomplicationsadenocarcinomaquality of lifeMetricsAuthor Information Wesley M. White Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee More articles by this author Natalia Sadetsky Department of Urology, University of California-San Francisco, San Francisco, California More articles by this author W. Bedford Waters Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee More articles by this author Peter R. Carroll Department of Urology, University of California-San Francisco, San Francisco, California More articles by this author Mark S. Litwin Department of Urology, University of California-Los Angeles, Los Angeles, California More articles by this author Expand All Advertisement PDF downloadLoading ...