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Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer

PURPOSE: To compare long-term (4–10 years) quality of life (QoL) of men with low-risk prostate cancer (PCa) treated by different modalities and a reference group without PCa. METHODS: In this cross-sectional study, four groups were sent a one-time QoL-questionnaire; PCa patients (1) following the st...

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Autores principales: Venderbos, Lionne D. F., Aluwini, Shafak, Roobol, Monique J., Bokhorst, Leonard P., Oomens, Eric H. G. M., Bangma, Chris H., Korfage, Ida J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420369/
https://www.ncbi.nlm.nih.gov/pubmed/28168601
http://dx.doi.org/10.1007/s11136-017-1507-7
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author Venderbos, Lionne D. F.
Aluwini, Shafak
Roobol, Monique J.
Bokhorst, Leonard P.
Oomens, Eric H. G. M.
Bangma, Chris H.
Korfage, Ida J.
author_facet Venderbos, Lionne D. F.
Aluwini, Shafak
Roobol, Monique J.
Bokhorst, Leonard P.
Oomens, Eric H. G. M.
Bangma, Chris H.
Korfage, Ida J.
author_sort Venderbos, Lionne D. F.
collection PubMed
description PURPOSE: To compare long-term (4–10 years) quality of life (QoL) of men with low-risk prostate cancer (PCa) treated by different modalities and a reference group without PCa. METHODS: In this cross-sectional study, four groups were sent a one-time QoL-questionnaire; PCa patients (1) following the structured Prostate cancer Research International Active Surveillance protocol, (2) who underwent radical prostatectomy (RP) in the context of the European Randomized study of Screening for Prostate Cancer—section Rotterdam, (3) who underwent radiotherapy (RT) at an academic hospital in The Netherlands, and (4) an age-matched reference group of men without PCa. The QoL-questionnaire addressed prostate-specific health (EPIC), generic health (SF-12), and anxiety (STAI-6). Statistical significance (p ≤ 0.05) and clinical relevance (≥0.5 SD) of differences between groups were assessed. RESULTS: The AS, RP, RT, and reference group response rates amounted to 74% (122/165), 66% (70/106), 66% (221/335), and 75% (205/273), respectively. At a mean of 6.6 years of follow-up, active surveillance (AS)-men reported better urinary function [M = 93.0 (SD = 10.6) vs. 80.0 (SD = 19.1), p ≤ 0.001], less urinary incontinence [M = 90.0 (SD = 14.6) vs. 70.1 (SD = 28.8), p ≤ 0.001], and better sexual function [M = 40.9 (SD = 24.6) vs. 14.8 (17.7), p ≤ 0.001, clinically relevant] than RP-men. Compared to RT, AS-men reported better sexual function [M = 40.9 (SD = 24.6) vs. 25.8 (SD = 25.0), p = 0.069]. The four groups reported similarly low anxiety levels; the number of highly anxious men (STAI ≥ 44) ranged from 8 to 13%. For all QoL domains, men on AS and men without PCa reported very similar scores. CONCLUSIONS: Prostate-specific function of AS-men was significantly better than that of RP-men. When comparing AS to RT, a borderline significant difference in sexual function was seen. Men who followed an AS strategy for a long-term period were not anxious and accepted it well, suggesting that AS may be a good treatment option for men with low-risk PCa.
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spelling pubmed-54203692017-05-22 Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer Venderbos, Lionne D. F. Aluwini, Shafak Roobol, Monique J. Bokhorst, Leonard P. Oomens, Eric H. G. M. Bangma, Chris H. Korfage, Ida J. Qual Life Res Article PURPOSE: To compare long-term (4–10 years) quality of life (QoL) of men with low-risk prostate cancer (PCa) treated by different modalities and a reference group without PCa. METHODS: In this cross-sectional study, four groups were sent a one-time QoL-questionnaire; PCa patients (1) following the structured Prostate cancer Research International Active Surveillance protocol, (2) who underwent radical prostatectomy (RP) in the context of the European Randomized study of Screening for Prostate Cancer—section Rotterdam, (3) who underwent radiotherapy (RT) at an academic hospital in The Netherlands, and (4) an age-matched reference group of men without PCa. The QoL-questionnaire addressed prostate-specific health (EPIC), generic health (SF-12), and anxiety (STAI-6). Statistical significance (p ≤ 0.05) and clinical relevance (≥0.5 SD) of differences between groups were assessed. RESULTS: The AS, RP, RT, and reference group response rates amounted to 74% (122/165), 66% (70/106), 66% (221/335), and 75% (205/273), respectively. At a mean of 6.6 years of follow-up, active surveillance (AS)-men reported better urinary function [M = 93.0 (SD = 10.6) vs. 80.0 (SD = 19.1), p ≤ 0.001], less urinary incontinence [M = 90.0 (SD = 14.6) vs. 70.1 (SD = 28.8), p ≤ 0.001], and better sexual function [M = 40.9 (SD = 24.6) vs. 14.8 (17.7), p ≤ 0.001, clinically relevant] than RP-men. Compared to RT, AS-men reported better sexual function [M = 40.9 (SD = 24.6) vs. 25.8 (SD = 25.0), p = 0.069]. The four groups reported similarly low anxiety levels; the number of highly anxious men (STAI ≥ 44) ranged from 8 to 13%. For all QoL domains, men on AS and men without PCa reported very similar scores. CONCLUSIONS: Prostate-specific function of AS-men was significantly better than that of RP-men. When comparing AS to RT, a borderline significant difference in sexual function was seen. Men who followed an AS strategy for a long-term period were not anxious and accepted it well, suggesting that AS may be a good treatment option for men with low-risk PCa. Springer International Publishing 2017-02-06 2017 /pmc/articles/PMC5420369/ /pubmed/28168601 http://dx.doi.org/10.1007/s11136-017-1507-7 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Article
Venderbos, Lionne D. F.
Aluwini, Shafak
Roobol, Monique J.
Bokhorst, Leonard P.
Oomens, Eric H. G. M.
Bangma, Chris H.
Korfage, Ida J.
Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title_full Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title_fullStr Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title_full_unstemmed Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title_short Long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
title_sort long-term follow-up after active surveillance or curative treatment: quality-of-life outcomes of men with low-risk prostate cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420369/
https://www.ncbi.nlm.nih.gov/pubmed/28168601
http://dx.doi.org/10.1007/s11136-017-1507-7
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