Journal Article

Impact on quality of life 3 years after diagnosis of prostate cancer patients below 75 at diagnosis: an observational case-control study

Bouvet, Sophie, Rébillard, Xavier, Kabani, Sarah, Fabbro-Peray, Pascale, Trétarre, Brigitte, Houédé, Nadine, Ménégaux, Florence

2020

Overview

Background Prostate cancer patients are known to suffer from poor sexual and urinary long-term side-effects following treatment, potentially impacting quality of life. The purpose of our study was to compare health-related quality of life at 3 years between prostate cancer patients and healthy controls according to key life-style characteristics. Secondary objectives were to compare urological dysfunction, sexual function, anxiety and depression. Methods Multicentric, case-control, observational prospective, open, follow-up study including 819 prostate cancer patients < 75 years old from the EPICAP cohort, newly diagnosed from 1 December 2011 to 31 March 2014 and 879 healthy controls. Participants were excluded if they experienced a relapse. Controls from the same geographical region were age-matched and were excluded if they were diagnosed with prostate cancer. Patients received one of the following treatments: active surveillance (AS), radical prostatectomy (RP), external beam radiotherapy (EBRT), High-intensity Focused Ultrasound (HIFU), chemotherapy (CT), or androgen deprivation therapy (ADT) as appropriate. The primary outcome was the quality of life as evaluated by the QLQ-C30 questionnaire. Scores were analyzed by multivariate analysis to adjust for predefined socio-demographic confounding effects. Results In total, 564 participants were included (mean age 67.9 years): 376 patients and 188 controls. Treatment breakdown was: 258 underwent RP, 90 received EBRT, 52 brachytherapy or HIFU, 15 CT, 26 ADT and 61 AS. There was no difference in median global quality of life between patients and controls (94.87 vs 94.15, p  = 0.71). Multivariate analysis showed poorer social functioning in patients (24.3% vs. 16.3%, p  = 0.0209), more dyspnea (22% vs. 12.4%, p  = 0.0078), and yet less current pain (23% vs 33%, p  = 0.0151). Conclusions Global health status score at 3 years after diagnosis was similar between patients and controls, though patients showed a significantly worse social functioning. Prostate cancer diagnosis per se does not seem to impact the quality of life of patients < 75 years at diagnosis. However, the therapeutic option that will be chosen following diagnosis should be carefully discussed with the medical staff in terms of benefit-risk ratios as it could have a long-term impact on urinary or erectile dysfunction. Trial registration clinicaltrials.gov, NCT02854982 . Registered 4 August 2016, retrospectively registered.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / Aged / Analysis / Androgen Antagonists - therapeutic use / Antineoplastic Agents - therapeutic use / Biomedical and Life Sciences / Biomedicine / Brachytherapy / Cancer / Cancer diagnosis / Cancer patients / Cancer Research / Cancer surgery / Cancer therapies / Care and treatment / Case-Control Studies / Chemotherapy / Chronic illnesses / Cohort Studies / Diagnosis / Dyspnea / Endocrine therapy / Epidemiology / Erectile dysfunction / Erectile Dysfunction - etiology / Extracorporeal Shockwave Therapy - statistics & numerical data / Health Promotion and Disease Prevention / Health Surveys - statistics & numerical data / Human health and pathology / Humans / Impotence / Insomnia / Life Sciences / Long term survival / Male / Medicine/Public Health / Middle Aged / Multivariate analysis / Oncology / Patients / prevention and public health / Prospective Studies / Prostate cancer / Prostatectomy / Prostatectomy - statistics & numerical data / Prostatic Neoplasms - complications / Prostatic Neoplasms - diagnosis / Prostatic Neoplasms - psychology / Prostatic Neoplasms - therapy / Quality of Life / Questionnaires / Radiation therapy / Radiotherapy - statistics & numerical data / Research Article / Respiration / Santé publique et épidémiologie / Side effects / Surgical Oncology / Surveillance / Surveys and Questionnaires / Time Factors / Ultrasound / Urinary dysfunction / Urological surgery / Urology and Nephrology / Watchful Waiting - statistics & numerical data