Quality of life after radical prostatectomy in Japanese men: A 5‐Year follow up study

Abstract

Objectives: To measure health-related quality of life (HRQOL) after radical prostatectomy (RP) in Japanese men with localized prostate cancer. Methods: A total of 154 patients who underwent RP were included in this 5-year longitudinal survey. The Short Form 36-Item Health Survey, the University of California, Los Angeles, Prostate Cancer Index and the International Prostate Symptom Score questionnaires were administered at diagnosis and nine times afterwards. Results: Patients undergoing RP showed problems in some physical domains of general HRQOL, but these problems diminished over time. Mental health and social functions significantly improved during the follow-up period. The urinary function substantially declined at 3 months and continued to recover gradually but never returned to baseline. Most patients (95%) recovered to their baseline urinary bother score within 60 months. The overall mean total International Prostate Symptom Score progressively improved with time. On the other hand , at 60 months after RP, only 34% of subjects had fully returned to baseline sexual function. By 5 years postoperatively, 78% of the men had reached baseline sexual bother and the mean recovery time was 8.6 months. Adverse effects of RP on sexual function and bother were mitigated by bilateral nervesparing procedures up to 5 years after the operation. Conclusions: Despite reported problems with sexuality and urinary continence, general HRQOL was mostly unaffected by RP after 6 months in our survey with functional outcomes remaining relatively stable in the majority of patients.Key words: longitudinal study, prostate cancer, quality of life, radical prostatectomy. IntroductionCurrently, the most common therapeutic options for localized prostate cancer are radical prostatectomy (RP), external radiation, and interstitial brachytherapy. RP is considered an especially safe and effective treatment for localized prostate cancer and has gained popularity among Japanese urologists over the last decade.1 As prostate cancer is increasingly diagnosed at early stages and therefore with more favorable survival outcomes, the basis on which patients select primary therapy has shifted toward considerations of health-related quality of life (HRQOL). 2,3Accordingly, HRQOL assessment has become an important form of outcome-based research that may weigh heavily on the justification of health care expenditures and the treatment selection by patients.Several assessments of HRQOL after prostate cancer treatment have been limited to studies of non-Hispanic whites, African-Americans, and Hispanics in the USA.4,5 Previously, we detailed HRQOL recovery in Japanese men with localized prostate cancer followed for 2 years after RP. 6 In the current analysis we assessed temporal changes in HRQOL up to 5 years following RP using validated questionnaires. To our knowledge the current study is the longest-term prospective study to assess the impact of RP on general and disease-specific outcomes following RP in Japanese men with clinically localized prostate can...

Long-term quality of life following primary treatment in men with clinical stage T3 prostate cancer

“…In the current study, 44% of the patients did not return to baseline values, which was consistent with other reports of similar scores in the recovery of urinary control after surgery [6,16]. We compared these results with those from our previous study that assessed the patients with early prostate cancer [17]. The previous study showed higher rates of urinary control, with more than 80% of the patients recovering to the baseline urinary function score at 60 months.…”

Quality of life among elderly men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy

“…It is important to emphasize that urinary incontinence after RP increases with age (Stanford et al 2000). Our previous survey revealed that 88% younger men (younger than 60) reached baseline urinary function at 24 months postoperatively using the same methods (Namiki et al 2009). In the current study, however, only 54% of patients returned to baseline values, which was less than that observed in younger RP subjects.…”

Robotic-assisted laparoscopic prostatectomy

“…While oncological and functional outcomes are routinely evaluated, quality of life (QoL) is often overlooked. Namiki et al (2009) have studied the effect of open RP on QoL using the Short Form 36-Item Health Survey (SF-36) and other prostate-specific questionnaires, and showed that by 5 years most men had returned to baseline levels of QoL. White et al (2008) compared QoL outcomes for patients from the CapSURE database with locally advanced prostate cancer undergoing different treatments, and showed that all treatments were associated with reductions in QoL scores, although they were unable to determine the 'best' treatment with regards to QoL.…”