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Quality of Life Research
Published in: Quality of Life Research 8/2014

01-10-2014

Health-related quality of life following radical prostatectomy: long-term outcomes

Authors: Andrew G. Matthew, Shabbir M. H. Alibhai, Tal Davidson, Kristen L. Currie, Haiyan Jiang, Murray Krahn, Neil E. Fleshner, Robin Kalnin, Alyssa S. Louis, B. Joyce Davison, John Trachtenberg

Published in: Quality of Life Research | Issue 8/2014

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Abstract

Purpose

To identify the health-related quality of life (HRQoL) domains that radical prostatectomy (RP) impacts most negatively and to define the recovery of these domains over 30 months of observation.

Patients and methods

A total of 1,200 RP patients completed the Patient-Oriented Prostate Utility Scale-Psychometric (PORPUS-P; range 0–100, higher is better), a prostate cancer-specific HRQoL measure, prior to RP and at 0–3 (T1), 3–9 (T2), 9–18 (T3) and 18–30 (T4) months post-RP. HRQoL changes were examined using paired t tests and a mixed-effect growth curve model. Multivariable analyses were performed to investigate demographic and treatment factors predicting the change in HRQoL.

Results

Mean baseline PORPUS-P score, 83.1, fell to 66.5 (p < 0.001) at T1. Over time HRQoL improved but did not return to baseline (T4 mean 76.4, p < 0.001). Domain analysis revealed that sexual function (p < 0.001), sexual drive (p < 0.001), energy (p = 0.001) and bladder control (p < 0.001) failed to return to baseline at T4. Sexual function demonstrated the greatest impairment overall. The multivariable model revealed Black men experienced greater losses in global HRQoL compared with White men (coefficient −2.77, 95 % CI −5.00 to −0.54, p = 0.015). High baseline HRQoL, pro-erectile aid use and bilateral nerve-sparing were significantly associated with smaller reductions in HRQoL post-RP.

Conclusion

Overall HRQoL, sexual drive, sexual function, energy and bladder control do not return to preoperative levels within 30 months post-RP. Black patients experience the greatest reductions in HRQoL. HRQoL losses may be ameliorated by use of pro-erectile aids. These findings help to identify at-risk patient populations and inform survivorship programs.
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Metadata
Title
Health-related quality of life following radical prostatectomy: long-term outcomes
Authors
Andrew G. Matthew
Shabbir M. H. Alibhai
Tal Davidson
Kristen L. Currie
Haiyan Jiang
Murray Krahn
Neil E. Fleshner
Robin Kalnin
Alyssa S. Louis
B. Joyce Davison
John Trachtenberg
Publication date
01-10-2014
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 8/2014
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-014-0664-1

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