SUO 2017: Longitudinal Assessment Of Health-related Quality Of Life And Decisional Regret In Men With Localized Prostate Cancer

Washington, DC ( Introduction: Patients with clinically localized prostate cancer (PCa) are faced with the challenging process of selecting an optimal therapy for their disease. Treatment choice can impact health-related quality of life (HRQOL) specifically urinary, sexual, and bowel functioning that can further lead to the decisional regret. In this study, the authors assessed changes in domain-specific HRQOL and association with decisional regret in men treated with active surveillance (AS), open radical prostatectomy, robotic radical prostatectomy, and brachytherapy.

Methods: Men with clinically localized PCa from a single center during (2011-2014) were prospectively enrolled in the study. Patients with prior pelvic radiation therapy or surgery were excluded. HRQOL was assessed at baseline with survey collecting demographic information (6 items), urinary function (16 items), sexual function (19 items), bowel function (13 items), and global
health (12 items) information using Likert-type response. Post-treatment assessment was done at 1, 3, 6, 12, and 24 months with a survey assessing decisional regret, in addition to the functional domains assessed at baseline. Multivariable analysis with mixed effects model was fitted to account for baseline differences between subjects.

Results: A total of 556 patients were enrolled in the study. Treatment options selected by the patients were AS (18%), brachytherapy (19%), open radical prostatectomy (29%) and robotic radical prostatectomy (34%). Compared to the group of patients undergoing AS; sexual function, bowel function, urinary function, and global health score significantly changed with time from baseline (p<0.001) in all other treatment groups. Decisional regret score was similar in the treatment groups at 1 month postoperatively. However, there was greater decisional regret in men undergoing any other treatment compared to AS at subsequent time points. As might have been predicted, decline in urinary function and global health score were associated with increased decisional regret (p<0.001), while changes in bowel function and sexual function domain did not associate with the decisional regret.

Conclusion: The authors concluded that HRQOL domains significantly differ between the treatment groups with time after treatment selection. Decline in urinary and sexual function and global health domain are associated with increased decisional regret among patients.

Speaker: Sudhir Isharwal, Cleveland Clinic, Cleveland, OH, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC