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| Pàgina inicial > Articles > Articles publicats > Health-related quality of life in men with prostate cancer undergoing active surveillance versus radical prostatectomy, external-beam radiotherapy, prostate brachytherapy and reference population : |
(Hospital del Mar (Barcelona, Catalunya)) (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública) (Institut Hospital del Mar d'Investigacions Mèdiques) (Hospital del Mar (Barcelona, Catalunya)) (Hospital del Mar (Barcelona, Catalunya))| Data: | 2019 |
| Resum: | The purpose of this study is to describe Health-Related Quality of Life (HRQoL) of localized prostate cancer patients in an Active Surveillance (AS) program, and to compare them with those undergoing radical prostatectomy (RP), external-beam radiotherapy (XRT) and brachytherapy (BT). Multi-institutional pooled cross-sectional analysis on patients in an AS protocol: 75 years old; pathologically confirmed LPC (maximum of three positive cylinders); Gleason score 3 + 4; clinical stage T1a-T2b; and PSA < 15 ng/ml. Exclusion criteria for this study were: less than 6 months in AS, termination of AS protocol, or incomplete data. Patients in AS were matched with those treated with RP, XRT or BT from the 'Spanish Multicentric Study of Clinically Localized Prostate Cancer' cohort according to risk group, time from treatment selection to HRQoL survey, and age. Prostate-specific (EPIC) and generic (SF-36) HRQoL instruments were completed. Analysis was stratified by HRQoL survey moment (>or 2. 5 years from treatment selection), and age (>or 70 years old). Median of time from treatment selection to HRQoL survey in the total 396 patients (99 per treatment group) was 2. 4 years (range 0. 5–8. 3). Patients in AS presented higher (better) urinary incontinence scores than RP ones in both stratus of time from treatment selection to HRQoL survey (92. 6 vs 67. 0 and 81. 4 vs 64. 4, p < 0. 01). Patients in AS for 2. 5 years presented greater sexual scores than any active treatment (p < 0. 01), but only statistically higher than RP for those in AS for longer than 2. 5 years. The magnitude of the differences between AS and RP groups in both EPIC domains ranged from moderate (0. 7 SD) to large (1. 0 SD). Regardless of treatment applied, patients presented similar and slightly increased SF-36 scores than US general population reference norms. Nonetheless, patients in AS for 2. 5 years reported worse outcomes than other treatment groups on physical health domains, especially in bodily pain (0. 5–0. 6 SD), and vitality (0. 6–0. 8 SD). Considering patients' well-being, AS can be a good therapeutic option due to the low impact caused on urinary continence and sexual function. However, longitudinal studies are required to take into account HRQoL evolution over time. The online version of this article (10. 1186/s12955-019-1082-4) contains supplementary material, which is available to authorized users. |
| Ajuts: | Instituto de Salud Carlos III PI11-01191 Instituto de Salud Carlos III PI13-00412 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014SGR748 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017SGR452 |
| Nota: | Altres ajuts: AATRM/086-24-2000 |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | Active surveillance ; Brachytherapy ; External-beam radiotherapy ; Health-related quality of life ; Radical prostatectomy |
| Publicat a: | Health and quality of life outcomes, Vol. 17 (january 2019) , ISSN 1477-7525 |
