Prostate Cancer Scientific - J

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Latest Prostate Cancer Abstract

Journal: BJU International.

Issue: 2006, 97(5):955-62.

Pubmed ID: 16643477

Authors: Jayadevappa R, Chhatre S, Whittington R, Bloom BS, Wein AJ, Malkowicz SB.

Title: Health-related quality of life and satisfaction with care among older men treated for prostate cancer with either radical prostatectomy or external beam radiation therapy.

OBJECTIVE: To analyse health-related quality of life and satisfaction with care across potential curative treatments for older patients newly diagnosed with prostate cancer.

PATIENTS AND METHODS: In a prospective cohort study we recruited 115 older patients (> or =65 years) newly diagnosed with prostate cancer from the urology clinics of an urban academic and a Veterans' Administration (VA) hospital. Patients completed generic (Short Form-36), prostate-specific (University of California Los Angeles Prostate Cancer Index) health-related quality of life, and Client Satisfaction with Care (CSQ-8) surveys before treatment with either radical prostatectomy or external beam irradiation and at 3, 6 and 12 months afterward. Clinical and demographic data were obtained via medical chart review. A repeated-measures analysis of variance was used to examine changes in generic and prostate cancer-specific health-related quality of life between treatments. Log-linear regression was used to analyse the factors associated with 12-month health-related quality of life scores, and Kaplan-Meier survival curves were used to compare the return to baseline values for health-related quality of life.

RESULTS: The radical prostatectomy group had significantly higher income, education and better general health than the external beam irradiation group. Age (odds ratio 0.5, 95% confidence interval 0.32-0.82), non-VA hospital (28.8, 2-402) and prostate-specific antigen level at diagnosis (2.8, 1.05-7.5) were associated with radical prostatectomy. The analysis results indicated that the RP group had higher scores for generic health-related quality of life subscales of physical function (P = 0.019), role emotional (P = 0.037), vitality (P = 0.033) and general health (P = 0.05) than the external beam irradiation group. A log-linear regression model for predicting the 12-month scores showed that radical prostatectomy was associated with higher scores for most of the generic health-related quality of life and bowel function (odds ratio 1.12, P = 0.03), urinary bother (1.6, P = 0.014) and bowel bother (1.5, P = 0.013). Being older was associated with a lower score on bowel function (0.98, P = 0.05) and sexual function (0.92, P = 0.05). Satisfaction with care was comparable between treatment groups at baseline and at the follow-up.

CONCLUSIONS: Older patients tolerate radical prostatectomy well from the health-related quality of life perspective and thus decisions for therapy in this age cohort should not be based primarily on age.

Contact: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104-2676, USA.

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