Health related quality of life assessment after radical prostatectomy in men with prostate specific antigen only recurrence
Health related quality of life assessment after radical prostatectomy in men with prostate specific antigen only recurrence
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DOI：
10.1016/s0022-5347(05)65552-8
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发表时间：
2001-12-01
影响因子：
6.6
通讯作者：
Cookson, MS
中科院分区：
文献类型：
--
作者：
Pietrow, PK;Parekh, DJ;Cookson, MS
目的：前列腺癌患者健康相关的生活质量评估变得越来越重要。同时，根治性耻骨后前列腺切除术后前列腺特异性抗原（PSA）升高患者的治疗仍存在争议。我们试图确定PSA复发对根治性耻骨后前列腺切除术后患者健康相关生活质量的影响。材料和方法：在1991年3月至1998年9月期间，604例连续行根治性耻骨后前列腺切除术的患者中，510例（84%）可随访。每位患者都邮寄了兰德36项健康调查和加州大学洛杉矶分校前列腺癌指数问卷。共回收问卷348份（70%）。然后比较有和没有PSA复发的患者的健康相关生活质量评分。还进行了多变量分析，以进一步阐明组间差异的原因。结果：总体而言，88例（25%）患者出现PSA复发。在与健康相关的生活质量方面，4个身体健康领域中的2个存在很小（小于10%）但具有统计学意义的差异（RAND 36项健康调查）。PSA复发患者的心理健康领域只有1个类别有显著下降。只有性功能在统计上低于加州大学洛杉矶分校的前列腺癌指数。这一结果反映了这些患者神经保留的发生率较低，多因素分析证实了这一点。有和没有PSA复发的患者总体满意度相似（分别为76%和79%）。结论：我们的研究表明生化PSA复发患者与未复发患者的健康相关生活质量差异很小。这些发现为这些患者的一般和特定疾病的健康相关生活质量领域提供了基线评估。未来的研究应关注这些无症状患者在辅助治疗前后癌症焦虑测量的差异。
Purpose: The health related quality of life assessment is becoming increasingly important among patients with prostate cancer. Meanwhile, treatment of patients with increasing prostate specific antigen (PSA) after radical retropubic prostatectomy remains controversial. We attempt to define the impact of PSA recurrence on the health related quality of life of patients after radical retropubic prostatectomy.Materials and Methods: Of 604 consecutive patients who underwent radical retropubic prostatectomy between March 1991 and September 1998, 510 (84%) were available for followup. Each patient was mailed the RAND 36-Item Health Survey and University of California, Los Angeles, Prostate Cancer Index questionnaire. A total of 348 (70%) questionnaires were returned. Health related quality of life scores were then compared between patients with and without PSA recurrence. A multivariate analysis was also performed to elucidate further the cause of differences between the groups.Results: Overall, 88 (25%) patients had PSA recurrence. In regard to health related quality of life there were small (less than 10%) but statistically significant differences in 2 of 4 physical health domains (RAND 36-Item Health Survey). There was a significant decrease in only 1 category of the mental health domain for patients with PSA recurrence. Only sexual function was statistically lower on the University of California, Los Angeles, Prostate Cancer Index. This result reflects the lower incidence of nerve sparing in these patients, as confirmed by the multivariate analysis. Overall patient satisfaction was similar between those with and without PSA recurrence (76% and 79%, respectively).Conclusions: Our study demonstrates small health related quality of life differences in patients with biochemical PSA recurrence versus those without. These findings provide a baseline assessment of general and disease specific health related quality of life domains among these patients. Future studies should focus on differences in the measure of cancer anxiety before and after administration of adjuvant therapy in these asymptomatic patients.