MP58-19 PATIENT-REPORTED HEALTH RELATED QUALITY-OF-LIFE (HRQOL) OUTCOMES OF PATIENTS ON ACTIVE SURVEILLANCE: RESULTS OF A PROSPECTIVE, LONGITUDINAL, SINGLE-CENTER STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VI1 Apr 2014MP58-19 PATIENT-REPORTED HEALTH RELATED QUALITY-OF-LIFE (HRQOL) OUTCOMES OF PATIENTS ON ACTIVE SURVEILLANCE: RESULTS OF A PROSPECTIVE, LONGITUDINAL, SINGLE-CENTER STUDY Cesar Ercole, Tracy Krebs, Donna Prots, Ryan Berglund, Jay Ciezki, Steven Campbell, Amr Fergany, Michael Gong, Georges-Pascal Haber, Stephen Jones, Jihad Kaouk, Eric Klein, Matthew Simmons, Robert Stein, Kevin Stephans, Rahul Tendulkar, Tianming Gao, and Andrew Stephenson Cesar ErcoleCesar Ercole , Tracy KrebsTracy Krebs , Donna ProtsDonna Prots , Ryan BerglundRyan Berglund , Jay CiezkiJay Ciezki , Steven CampbellSteven Campbell , Amr FerganyAmr Fergany , Michael GongMichael Gong , Georges-Pascal HaberGeorges-Pascal Haber , Stephen JonesStephen Jones , Jihad KaoukJihad Kaouk , Eric KleinEric Klein , Matthew SimmonsMatthew Simmons , Robert SteinRobert Stein , Kevin StephansKevin Stephans , Rahul TendulkarRahul Tendulkar , Tianming GaoTianming Gao , and Andrew StephensonAndrew Stephenson View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1835AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment options for clinically localized PCa may negatively impact a patient's HRQOL to varying degree. Active surveillance (AS) offers patients the potential for preservation of HRQOL without compromising curability. However, there is a lack of prospective, patient-reported data on the HRQOL outcomes of patients managed by AS relative to radical prostatectomy (RP) and brachytherapy (BT). From a prospective, longitudinal HRQOL protocol using validated instruments for patient-reported functional outcomes, we analyzed voiding, bowel, sexual function, urinary incontinence, and physical/emotional functioning among patients managed by AS, RP, and BT at our institution. METHODS Between 2007-2013, 591 patients PCa were enrolled in a prospective, longitudinal HRQOL protocol. HRQOL domains were assessed at various time points by a 48-item validated HRQOL instrument (Giesler et al. Qual Life Res 2000). Overall, 67 patients were managed by AS, 116 by BT, and 407 with RP (174 open and 223 robotic). A mixed effect model with random intercepts was fitted to the longitudinal data. The time was treated as categorical instead of continuous to reflect possible non-linear time trend. RESULTS Statistically significant differences for BT compared to AS and RP were noted for voiding (irritative and obstructive symptoms) and bowel function, where patients reported worsening symptoms as soon as 6 months with partial recovery ≥ 12 months (P value < 0.001 for all). Erectile function and incontinence were most affected by RP when compared to AS and BT, with recovery also noted ≥ 12 months (P value < 0.001 for all). Each domain is illustrated in Figure 1. CONCLUSIONS HRQOL among patients on AS is stable over 1-2 years for all domains. Urinary and bowel function for AS is significantly better than BT. Sexual function and incontinence for AS is significantly better than RP. This information is anticipated to be useful for patients and physicians when deciding upon the merits of AS over radical therapy for the treatment of localized PCa. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e665 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Cesar Ercole More articles by this author Tracy Krebs More articles by this author Donna Prots More articles by this author Ryan Berglund More articles by this author Jay Ciezki More articles by this author Steven Campbell More articles by this author Amr Fergany More articles by this author Michael Gong More articles by this author Georges-Pascal Haber More articles by this author Stephen Jones More articles by this author Jihad Kaouk More articles by this author Eric Klein More articles by this author Matthew Simmons More articles by this author R