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67th Annual Meeting Abstracts
Quality of Life after Open or Robotic Prostatectomy, Cryoablation, or Brachytherapy for Localized Prostate Cancer
John B Malcolm, *James Brien, Michael D Fabrizio, *Bethany B Barone, Robert W Given, Raymond S Lance, Paul F Schellhammer
Eastern Virginia Medical School, Norfolk, VA
Introduction: Health related quality of life (HRQOL) concerns factor prominently in prostate cancer management. We describe HRQOL impact and recovery profiles of four commonly used invasive treatments for localized prostate cancer.
Methods: Beginning February 2000, all patients undergoing treatment by open radical prostatectomy (ORP), robot-assisted laparoscopic prostatectomy (RAP), brachytherapy (BT), or cryotherapy (CT) were asked to complete the UCLA Prostate Cancer Index questionnaire before treatment and at 3, 6, 12, 18, 24, 30, and 36 months following treatment. Outcomes were compared across treatment types with statistical analysis utilizing univariate and multivariate models.
Results: 785 patients treated between February 2000 and December 2008 were included in the analysis, with a mean follow-up of 24 months. All HRQOL domains were adversely affected by all treatments, and recovery profiles varied significantly by treatment type. Overall, urinary function and bother outcomes were significantly better after BT and TCAP compared to ORP and RAP. BT and CT had a three-fold higher rate of return to baseline urinary function compared to ORP and RAP (Cox proportional hazards). Sexual function and bother outcomes were best after BT, with a five-fold higher rate of return to baseline function compared to TCAP, ORP, and RAP. Bowel function and bother scores suggested mild and transient negative impact for all four treatments.
Conclusions: Based on sequential HRQOL assessments, BT and CT are associated with superior urinary function and bother outcomes compared to ORP and DVP. BT is associated with superior sexual function and bother outcomes compared to ORP, RAP, and CT.
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