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Health Related Quality of Life of patients undergoing active surveillance – comparison with prostate cancer active treatments

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Sources of Funding: This work was supported by grants from Instituto de Salud Carlos III FEDER (FIS PI11/01191 y FIS PI13/00412) and DIUE of Generalitat de Catalunya (2014 SGR 748)

Introduction

Active surveillance in localised prostate cancer is an accepted option in selected cases, but some concerns still needs to be clarified. We pretend to evaluate Health-Related Quality of Life (HRQoL), in a cross-sectional study, in patients with localized prostate cancer undergoing active surveillance (AS) compared with active treatments (radical prostatectomy, external-beam radiotherapy, brachytherapy) and general population.

Methods

Ninety-nine patients fulfilled the inclusion criteria. This group was compared to different active treatments (n=99 per group) from the ‘Spanish Multicentric Study of Clinically Localized Prostate Cancer’ cohort using prostate-specific (Expanded Prostate Cancer Index Composite [EPIC]) and generic (36-Item Short Form Health Survey, version 2 [SF-36]) QoL instruments. SF-36 results were also compared to US reference population.

Results

Cross-section analysis was performed at 24 months after initial therapy or AS beginning. AS group presented statistically higher sexual scores [54.4 mean score (28.3 SD)] when compared to all other active treatments and better urinary incontinence scores [87.4 (22.8 SD)] than radical prostatectomy group [65.8 (31.6 SD)]. Patients undergoing AS were more likely to present significant urinary irritative/obstructive symptoms compared to radical prostatectomy group. No statistically significant differences were found among other domains. Patients with localized prostate cancer, regardless of treatment applied, presented slightly higher SF-36 physical and mental dimension scores (except for radical prostatectomy) than US general population reference norm (men aged 65-74).

Conclusions

AS may be a good treatment option for low or intermediate risk prostate cancer since induces the least impact in QoL. No significant differences were found on Physical and Mental Component Summaries compared to general US population. This study provides cross-sectional information about AS impact on QoL.

Funding

This work was supported by grants from Instituto de Salud Carlos III FEDER (FIS PI11/01191 y FIS PI13/00412) and DIUE of Generalitat de Catalunya (2014 SGR 748)

Authors
Lluis Fumado
Jose Francisco Suárez
Olatz Garín
Andrea Sureda
Montse Ferrer
Manel Castells
Jose Maria Abascal
Maria Carme Mir
Xavier Bonet
Helena Vila
Lluís Cecchini
Francesc Vigués
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