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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Nora Eisemann, Sandra Nolte, Maike Schnoor, Alexander Katalinic, Volker Rohde, Annika Waldmann
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12894-015-0025-6) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

NE made substantial contributions to the design of the analysis, to the statistical analysis and interpretation, and to drafting the manuscript. SN made substantial contributions to drafting the manuscript and to revising it critically for important intellectual content. MS contributed to the statistical analysis and to drafting the manuscript. AK made substantial contributions to drafting the manuscript and to revising it critically for important intellectual content. VR planned the study and was involved in data acquisition and revised the manuscript for important intellectual content. AW contributed to the planning of the analysis, to the statistical analysis, interpretation of results, and drafting the manuscript. All authors gave final approval of the final manuscript.

Abstract

Background

This study describes and compares health-related quality of life (HRQOL) of prostate cancer patients who received either radical prostatectomy (nerve-sparing, nsRP, or non-nerve-sparing, nnsRP) or radiotherapy (external RT, brachytherapy, or both combined) for treatment of localised prostate cancer.

Methods

The prospective, multicenter cohort study included 529 patients. Questionnaires included the IIEF, QLQ-C30, and PORPUS-P. Data were collected before (baseline), three, six, twelve, and twenty-four months after treatment. Differences between groups’ baseline characteristics were assessed; changes over time were analysed with generalised estimating equations (GEE). Missing values were treated with multiple imputation. Further, scores at baseline and end of follow-up were compared to German reference data.

Results

The typical time trend was a decrease of average HRQOL three months after treatment followed by (partial) recovery. RP patients experienced considerable impairment in sexual functioning. The covariate-adjusted GEE identified a significant - but not clinically relevant - treatment effect for diarrhoea (b = 7.0 for RT, p = 0.006) and PORPUS-P (b = 2.3 for nsRP, b = 2.2 for RT, p = 0.045) compared to the reference nnsRP. Most of the HRQOL scores were comparable to German norm values.

Conclusions

Findings from previous research were reproduced in a specific setting of a patient cohort in the German health care system. According to the principle of evidence-based medicine, this strengthens the messages regarding treatment in prostate cancer and its impacts on patients’ health-related quality of life. After adjustment for baseline HRQOL and other covariates, RT patients reported increased symptoms of diarrhoea, and nnsRP patients decreased prostate-specific HRQOL. RP patients experienced considerable impairment in sexual functioning. These differences should be taken into account by physicians when choosing the best therapy for a patient.
Zusatzmaterial
Additional file 1: Sexual functioning Radiotherapy Subgroups.tiff. Sexual functioning in the radiotherapy subgroups. Mean scores of brachytherapy, external radiotherapy, and combined radiotherapy cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (circle: brachyRT, triangle: externRT, cross: combRT).
12894_2015_25_MOESM1_ESM.tiff
Additional file 2: QLQ-C30 Radiotherapy Subgroups.tiff. Health-related quality of life in the radiotherapy subgroups. Mean scores of brachytherapy, external radiotherapy, and combined radiotherapy cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (circle: brachyRT, triangle: externRT, cross: combRT).
12894_2015_25_MOESM2_ESM.tiff
Additional file 3: PorpusP Radiotherapy Subgroups.tiff. PORPUS-P in the radiotherapy subgroups. Mean scores of brachytherapy, external radiotherapy, and combined radiotherapy cancer patients at baseline and during the 24-month follow-up period after multiple imputation of missing values (circle: brachyRT, triangle: externRT, cross: combRT).
12894_2015_25_MOESM3_ESM.tiff
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