Prospective quality‐of‐life outcomes for low‐risk prostate cancer: Active surveillance versus radical prostatectomy

Jeldres, Claudio; Cullen, Jennifer; Hurwitz, Lauren M.; Wolff, Erika M.; Levie, Katherine; Odem‐Davis, Katherine; Johnston, Richard B.; Pham, Khanh; Rosner, Inger L.; Brand, Timothy C.; L’Esperance, James O.; Sterbis, Joseph R.; Etzioni, Ruth; Porter, Christopher R.

doi:10.1002/cncr.29370

Cited by 57 publications

(54 citation statements)

References 34 publications

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“…Other studies found similar results among no treated patients and surgery (Jeldres et al, 2015;Donovan et al, 2016;Fosså et al, 2016). Other studies found similar results among no treated patients and surgery (Jeldres et al, 2015;Donovan et al, 2016;Fosså et al, 2016).…”

Section: Discussionmentioning

confidence: 65%

Health‐related quality of life in prostate cancer patients' – treatment comparisons

Sebakk

Haug

Gullan

et al. 2017

Int J of Uro Nursing

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Active surveillance (AS) as treatment option for prostate cancer (PCa) has been systematically offered from Vestfold Hospital Trust since 2009. This option proposes delay or avoidance of radical treatment and its troublesome side effects especially urinary leakage and erectile dysfunction. The aim is to compare urinary problems, sexual dysfunction and health‐related quality of life (HRQOL) between Norwegian PCa patients undergoing radical retropubic prostatectomy (RRP) and AS. A cross‐sectional study of 330 PCa patients diagnosed between 2010 and 2014 at Vestfold Hospital Trust was performed, including 150 in an AS group and 180 in a RRP group. HRQOL was assessed using the SF‐12 questionnaire. Sexual and urinary function was assessed through excerpts from The Expanded Prostate Cancer Index‐50 Question (EPIC‐50). Continuous data was analysed with t‐tests, while categorical data was analysed with χ2‐tests. In addition, linear regression analysis was performed. No difference in HRQOL was observed between the two groups despite significant differences in urinary leakage and sexual function. The AS group had a significantly lower proportion of men with a Physical Component Score (PCS) ≤ 40. We did not find the same pattern for Mental Component Score (MCS). The difference in PCS was not significant after adjustment for treatment, age, relationship and other independent variables. The findings are important for nurses informing PCa patients eligible for AS. The majority of men adjust with their disease and report good HRQOL, despite urinary leakage and erectile dysfunction after RRP compared with nontreated men on AS.

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Section: Discussionmentioning

confidence: 65%

Health‐related quality of life in prostate cancer patients' – treatment comparisons

Sebakk

Haug

Gullan

et al. 2017

Int J of Uro Nursing

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“…Jeldres et al . compared prostatectomy (228 patients, mean age 58 years) and AS (77 patients, mean age 65 years) in terms of their influence on voiding and SF, using the EPIC‐26 and SF‐36 for 3 years . Their results showed no significant difference between the two groups in terms of the mental component score in general HRQOL, but SF, sexual bother score and urinary function decreased significantly in the prostatectomy group at all time points.…”

Section: Qol In Relation To Physical Status In As Compared With Othermentioning

confidence: 99%

“…Jeldres et al . compared an AS group with a prostatectomy group using EPIC and SF‐36 over time . According to the MCS score of SF‐36, there were no statistically significant decline in either group.…”

Section: Mental Condition Of Patients Choosing As In Comparison With mentioning

confidence: 99%

Quality of life in active surveillance for early prostate cancer

Kato

Sugimoto

2020

Int J of Urology

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Recently, the prevalence of the prostate‐specific antigen screening test for early‐stage prostate cancer has increased, but this has also resulted in an increase in insignificant cancers. The treatment outcome of early‐stage prostate cancer is excellent, but such a radical treatment also leaves the patient with undesired adverse consequences. To resolve such problems, attention should be paid to active surveillance as a modern treatment option. This study aimed to systematically review the literature about quality of life in prostate cancer patients undergoing active surveillance. Evidence was acquired from PubMed databases in March 2019 using quality of life, prostate cancer, well‐being, anxiety, depression, stress, outcomes, active surveillance, radiation therapy and radical prostatectomy as keywords. Five clinical active surveillance studies measured health‐related quality of life and related psychological factors, and seven compared active surveillance with other treatments (radical therapy and hormone therapy). Active surveillance was superior to radical therapy for urinary and sexual function. Furthermore, most patients who opted for active surveillance showed lower anxiety and fear of progression, whereas health‐related quality of life was maintained. Although active surveillance has the advantage of being non‐invasive, its diagnosis and follow‐up protocols are unreliable. Because such uncertainty can affect patients’ quality of life, utilization of imaging modalities, such as magnetic resonance imaging, and the development of new biomarkers are required.

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“…Radical prostatectomy for localized PCa increases cancer-specific survival but it has been blamed for its negative impact on quality of life. [1][2][3] AS has been suggested as an alternative for selected low-risk PCa patients to decrease the side effects of definitive treatment. However there is considerable variation between studies regarding the patient selection and follow-up policies for AS.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted radical prostatectomy in low- and high-risk prostate cancer patients

Boylu¹,

Bindayı²,

Küçük³

et al. 2017

Turkish Journal of Urology

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Objective: To evaluate the benefit of robot-assisted radical prostatectomy (RARP) in the low-risk prostate cancer (PCa) patients suitable for active surveillance and in the high-risk PCa patients who would be considered for alternative treatments such as radiotherapy (RT) and androgen deprivation therapy (ADT) instead of radical prostatectomy. Material and methods:Of 548 patients, who underwent RARP, 298 PCa patients (258 low-risk and 40 high-risk) with a mean of 3.6 years follow-up, were included into this study. Oncological outcomes were compared separately in low-and high-risk PCa patients. Results:The pathologic Gleason scores were ≥7 in 73 (28%), and 68 (26%) patients had a pathologic stage of T3, 29 (11%) patients had a positive surgical margin (PSM), and 20 (7%) patients had biochemical recurrence (BCR) in the first year follow-up in the low-risk group. Of 258 low-risk PCa patients, a total of 93 (36%) patients had not either BCR, pathologic Gleason score ≥7, or ≥pT3 disease with PSM. In the high-risk group, the pathologic stage was pT2 in 14 (35%) patients and 29 (72%) patients had no biochemical recurrence in the follow-up of these high-risk PCa patients. Of 40 high-risk PCa patients, in a total of 25 (62.5%) patients ≥pT3b disease, BCR, pT3a disease with PSM were not detected. Conclusion:Approximately two thirds of high-risk PCa patients benefit from RARP without additional RT or ADT. Besides, more than one third of low-risk PCa patients who fit active surveillance criteria would have unfavorable results.

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Prospective quality‐of‐life outcomes for low‐risk prostate cancer: Active surveillance versus radical prostatectomy

Cited by 57 publications

References 34 publications

Health‐related quality of life in prostate cancer patients' – treatment comparisons

Health‐related quality of life in prostate cancer patients' – treatment comparisons

Quality of life in active surveillance for early prostate cancer

Robot-assisted radical prostatectomy in low- and high-risk prostate cancer patients

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