Evaluation of Health-Related Quality of Life in Patients with Prostate Cancer after Treatment with Radical Retropubic Prostatectomy and Permanent Prostate Brachytherapy

Abstract

Aim: The aims of this study were to evaluate the health-related quality of life (HRQOL) and make the treatment decision less difficult. Methods: Between 2007 and 2009 radical retropubic prostatectomy (RRP) was performed in 96 patients and permanent prostate brachytherapy (PPB) in 88 patients at our hospital. The general and disease-specific HRQOL was measured using two instruments, the Medical Outcome Study 8-Item Short-Form Health Survey (SF-8) and the expanded prostate index composite (EPIC). Results: Comparing RRP and PPB, there were significant differences in all scores except for general health in the 1st month after treatment which had the same score in both groups. The baseline quality of life scores in physical function (p < 0.05), physical role (p < 0.01), social functioning (p < 0.01), emotional role (p < 0.01) and mental health (p < 0.01) showed significant differences between the group and were better in the PPB group than in the RRP group. The physical component summary score in the PPB group was better than in the RRP group in the 1st month (p < 0.01) but recovered up to 3 months in the RRP group. The urinary bother and irritative/obstructive scores in the 1st month were worse from baseline in both groups (p < 0.05) and remained significantly worse up to 6 months in the PPB group than in the RRP group where these scores recovered within3 months. The urinary incontinence score in the RRP group was still worse than in the PPB group up to 12 months (p < 0.01). Bowel function and bother were significantly better in the RRP group at 3 (p < 0.05) and 6 months (p < 0.01) than in the PPB group where bowel function at 12 months was worse than at baseline and in the RRP group. Sexual function (p < 0.01) and sexual bother were better in the PPB group and did not change until 12 months. Conclusion: The difference in disease-specific quality of life has become clearer using EPIC. As with other published studies, our results provide important information that will therefore be useful for selecting the optimal treatments for localized prostate cancer.

Effects of stress, dyadic communication and adaptation on prostatectomy patients' quality of life

“…However, lower educational levels, older ages of the spouse, higher incomes and lower tumour stages have been reported to be associated with higher QOL (Song et al , ). Patients who received prostatectomy have been reported to have lower QOL than those treated with radiation therapy or hormone therapy (Krahn et al , ; Takizawa et al , ; Dragicevic et al , ); thus, efforts should be made to enhance the QOL of patients. Based on these findings, we propose that the relevant factors influencing the QOL of patients be identified and an intervention programme be developed in order to enhance the QOL of this patient population.…”

Initial Treatment Costs of Organ‐confined Prostate Cancer: A General Perspective

“…Dragićević et al . [6] evaluated HRQOL in patients after treatment with ORRP and prostate brachytherapy (BT). They measured general and disease‐specific HRQOL and found that there were significant differences in all scores except for general health in the 1st month after treatment.…”

Processo de recuperação cirúrgica em pacientes submetidos à prostatectomia radical: estudo longitudinal de variáveis sociodemográficas, clínicas e psicológicas

“…Quanto ao domínio da qualidade de vida direcionada à função sexual dos participantes, a literatura aponta resultados similares no mesmo período (VAN TOL-GEERDINK et al, 2013). Contudo, em relação aos escores da subescala de função sexual a média apresentada pelos participantes (M = 54,43; DP = 22,90) foi superior aos resultados médios apresentados na literatura (M = 28,3; DP = 21,5) (DRAGICEVIC et al, 2010). Por outo lado, em relação ao incômodo sexual apresentado pelos participantes nesta pesquisa (M = 63,07; DP = 30,13) os resultados divergiram do apresentado pela literatura, os quais foram superiores (M = 85,1; DP = 20,5) (DRAGICEVIC et al, 2010).…”

“…Em relação ao domínio de hábito intestinal (M= 88,6; DP = 9,97), quando avaliados a função intestinal e incômodo intestinal os participantes apresentaram dados (Tabela 13) similares ao da literatura (M = 85,7; DP = 13,7) para função intestinal (M = 94,5; DP = 7,2) para incômodo intestinal, respectivamente) (DRAGICEVIC et al, 2010).…”

“…A análise de cada uma das subescalas do EPIC aponta que a função urinária apresentada pelos participantes teve resultados médios ligeiramente inferiores aos obtidos no estudode Ferrer et al (2008) (M =83,2; DP = 1,5). Em relação à subescala função urinária, os participantes da presente pesquisa apresentaram resultado médio inferior ao citado na literatura (M = 85,4; DP = 15,1), assim como para incômodo urinário (M = 92,7; DP = 8,3), incontinência urinária (M = 81,1 DP = 20,7) e irritabilidade/obstrução urinária (M = 97,2; DP = 5,1)(DRAGICEVIC et al, 2010).Ainda, observa-se em relação ao escore total da avaliação de habito intestinal (M = 92,19; DP = 11,78) (Tabela 15) média inferior ao da literatura (M = 96,8; DP = 0,9)(FERRER et al, 2008); contudo, ao se analisar a função do habito intestinal, os participantes deste estudo apresentaram escores médio similar aos da literatura (M = 92,7; DP = 8,3), em contraposição aos relativos ao incômodo relacionado ao habito intestinal cujo escore médio foi ligeiramente inferior ao do estudo (M = 98,0; DP = 3,7) de Dragicevic et al(2010).A função sexual apresentada pelos participantes (M = 23,43; DP = 19,40) (Tabela 15), apresentou dados similares (M = 23,7; DP = 1,6) aos dados obtidos porFerrer et al (2008).Contudo, quando avaliado a subescala função sexual, os participantes de nosso estudo apresentaram escore médio superiores aos de Dragicevic et al(2010)(M = 5,1; DP = 9,5); Por outro lado, para o incômodo sexual observou-se o contrario ao se considerar os achados de Dragicevic et al (2010) (M = 85,3; DP = 21,7) em relação a qualidade de vida dos pacientes submetidos à prostatectomia radical no período de três meses. Quanto ao domínio da função hormonal (M = 86,75; DP = 17,75) (Tabela 15), a literatura apresentou resultados médios superiores (M = 93,4; DP = 1,0) (FERRER et al 2008).…”