Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification

Takizawa, Itsuhiro; Hara, Noboru; Nishiyama, Tsutomu; Kaneko, Masataka; Hoshii, Tatsuhiko; Tsuchida, Emiko; Takahashi, Kota

doi:10.1038/aja.2009.10

Cited by 20 publications

(11 citation statements)

References 31 publications

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“…Three thousand three hundred sixty three records were identified, and 25 studies were finally included in this systematic review and meta-analysis [11][12][13][14][15][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Due to a lack of data, 4 studies cannot be meta-analyzed, so we only presented the results of QoL in these studies.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

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The efficacy and safety of radical prostatectomy and radiotherapy in high-risk prostate cancer: a systematic review and meta-analysis

Wang

Chen

et al. 2020

World J Surg Onc

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Background: The optimal treatment for patients with high-risk prostate cancer (PCa) remains a debate and selection of patients to receive proper therapy is still an unsettled question. This systematic review was conducted to compare the effectiveness of prostatectomy (RP) and radiotherapy (RT) in patients with high-risk PCa and to select candidates for optimal treatment. Methods: PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched for eligible studies. We extracted hazard ratios (HRs) and 95% confidence interval (CI) of all included studies. The primary outcomes were overall survival (OS) and cancer-specific survival (CSS); the secondary outcomes were biochemical recurrencefree survival (BRFS), metastasis-free survival (MFS) and clinical recurrence-free survival (CRFS). The meta-analysis was performed using Review Manager 5.3. Subgroup analyses were conducted according to Gleason score (GS), T stage and RT types. Quality of life (QoL) was compared with these two treatments. Results: A total of 25 studies were included in this meta-analysis. Overall, RP showed more survival benefits than RT on CSS (P = 0.003) and OS (P = 0.002); while RT was associated with better BRFS (P = 0.002) and MFS (P = 0.004). Subgroup analyses showed RT was associated with similar or even better survival outcomes compared to RP in patients with high GS, high T stage or received external beam radiotherapy plus brachytherapy (EBRT + BT). As for QoL, RP was associated with poorer urinary and sexual function but better performance in the bowel domain. Conclusion: RP could prolong the survival time of patients with high-risk PCa; however, RT could delay the disease progression, and combined RT (EBRT + BT) even brought preferable CSS and similar OS compared to RP. RT might be the prior choice for patients with high T stage or high GS. RP could lead to poorer urinary and sexual function, while bringing better performance in the bowel domain.

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Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…Five studies demonstrated that RT performed better in urinary function. Only Takizawa reported there was no difference between RP and RT on urinary function in the high-risk group (P = 0.05) [23]. Three studies showed patients treated with RT had better sexual function than those treated with RP.…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

The efficacy and safety of radical prostatectomy and radiotherapy in high-risk prostate cancer: a systematic review and meta-analysis

Wang

Chen

et al. 2020

World J Surg Onc

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Kim

Ahn

2016

Int J of Uro Nursing

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This study investigates the effects of stress, dyadic communication and dyadic adaptation of patients who received prostatectomy and their spouses on the quality of life (QOL) of patients. A descriptive design was used with 113 prostatectomy couples. Data were collected from December 2012 to February 2014 at a prostate cancer centre in Korea. Stress, dyadic communication, dyadic adaptation and patient QOL were measured with the perceived stress scale, communication pattern questionnaire, Revised Dyadic Adjustment Scale and Functional Assessment of Cancer Treatment-Prostate, respectively. Emotional QOL of patients was negatively affected by stress ( = −0·624, p < 0·001) and mutual avoidance communication ( = −0·050, p = 0·001) of the patients as well as couple cohesion ( = −0·113, p = 0·015). The predictive power (F = 25·895, p < 0·001) was 41·6%. Social QOL of patients was negatively affected by patient stress ( = −0·331, p = 0·010) and positively affected by the constructive communication of the patients ( = 0·034, p = 0·006) and spouses ( = 0·029, p = 0·014) and withdrawal communication of the spouses ( = 0·035, p < 0·001), and the predictive power (F = 11·391, p < 0·001) was 29·7%. Functional QOL of patients was negatively affected by patient stress ( = −0·680, p < 0·001) and positively affected by the patients' assessment of couple cohesion n ( = 0·173, p = 0·007). The predictive power (F = 18·491, p < 0·001) was 25·2%. To improve the QOL of patients who received prostatectomy, a programme needs to be developed to reduce patient stress and improve constructive communication and couple cohesion.

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“…High quality evidence from contemporary clinical trials comparing radical prostatectomy with radiotherapy, surveillance, brachytherapy or minimally invasive techniques is either lacking or limited (Table 3). [61][62][63][64][65][66][67][68][69] Two early randomized studies compared prostatectomy against radiotherapy, using doses of 40-50 Gy to the whole pelvis with a 20 Gy prostatic boost. 61,62 A significant difference in disease progression was reported in favor of radical prostatectomy, although there was no significant difference in overall survival.…”

Section: Prostatectomy Outcomes Compared To Other Treatment Modalitiesmentioning

confidence: 99%

Is radical prostatectomy the best option for localized prostate cancer? Current opinion and research

Shelley¹,

Mason²

2010

OAS

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Open radical prostatectomy is an effective treatment for prostate cancer with a 5-year biochemical recurrence-free survival rate of about 90% for localized disease. For men with organ confined disease, the 10 year disease-specific survival rate approximates 95% following retropubic prostatectomy. Attempts to improve survival rates by combining androgen deprivation therapy with radical prostatectomy have been unsuccessful. Erectile dysfunction and urinary incontinence are common complications following open radical prostatectomy. In an attempt to reduce morbidity, laparoscopic approaches have been developed with reported 8-year cancer control rates of about 70%. Robotic laparoscopic approaches yield a trifecta rate of achieving continence, potency and being prostate-specific antigen recurrence-free at 2 years of 74%. Comparative studies do not provide evidence that one surgical approach is superior. Few randomized trials have compared surgery with the other primary therapies for prostate cancer. A Scandinavian randomized study has reported that the metastatic rate and overall mortality are significantly better with surgery compared to watchful waiting. However, there are no published data from randomized trials comparing surgery with radiotherapy (external beam or brachytherapy), active surveillance or minimally invasive procedures. There are ongoing randomized trials comparing surgery with radiotherapy, brachytherapy, and active surveillance, but until these are published, there is no conclusive evidence that surgery is the best primary option for localized or locally advanced prostate cancer.

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Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification

Cited by 20 publications

References 31 publications

The efficacy and safety of radical prostatectomy and radiotherapy in high-risk prostate cancer: a systematic review and meta-analysis

The efficacy and safety of radical prostatectomy and radiotherapy in high-risk prostate cancer: a systematic review and meta-analysis

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

Is radical prostatectomy the best option for localized prostate cancer? Current opinion and research

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