Abstract: PD18-05
Sources of Funding: none

Introduction

Amongst patients diagnosed with localised prostate cancer, the subsets of patients with low-risk disease are of particular interest since several evidence based therapeutic options are available to them, including radical prostatectomy (RP), radiotherapy, and active surveillance. To date, little is known about health-related quality of life with regard to patient satisfaction in general and the effect of perioperative patient counselling in particular. In the current study, we evaluate patient-reported functional outcomes after RP and analyze the effect of perioperative patient education on satisfaction rates among low-risk prostate cancer patients.

Methods

Inclusion criteria encompassed low-risk prostate cancer patients as defined by the D&[prime]Amico criteria, undergoing nerve-sparing RP excluding pelvic lymphadenectomy. Patient-centred functional outcomes, subjective evaluation of perioperative counselling, and patient satisfaction rates were documented. Stress urinary incontinence (SUI) was assessed by daily pad usage. Erectile dysfunction (ED) was assessed using IIEF5 score. Patients histories were attained from the electronic medical records. The effect of pre-defined predictive features for satisfaction rates was analysed in low-risk patients. Statistical analyses included Fisher exact test, Mann-Whitney-U test, and binary logistic regression models (p<0.05).

Results

266 patients met the inclusion criteria. Median follow-up was 94 months (68-118). The global satisfaction rate was 75.1%. Regarding SUI, 69.5% of patients required no pads, 67.1% felt very well informed, while 11.7 % felt poorly educated. Regarding ED, an IIEF score of ≥18 was reached by 33.7%. 59.6% felt very well educated, while 13.0% felt poorly informed. Poor patient counselling regarding SUI and ED led to significantly decreased long-term satisfaction rates [40.7%, 33.3% (p<0.001)]. In multivariate analysis, poor ED patient counselling [OR 0.190, 95%CI 0.055-0.652 (p=0.008)], and postoperative IIEF5 score [OR 3.061, 95%CI 1.013-3.111 (p=0.013)] could be confirmed as independent predictors for patient satisfaction.

Conclusions

In the current study, we provide a detailed patient-centred analysis of multiple functional outcome parameters in a long-term follow-up after RP. Firstly, our findings highlight the effect of perioperative patient education on long-term patient satisfaction rates. In addition, our results advocate a structured patient counselling process to increase the postoperative quality of life in low-risk prostate cancer patients that have undergone RP (instead of active surveillance).

Funding

none