To compare the quality of life (QOL) in patients who underwent robot-assisted radical prostatectomy (RARP) or low-dose-rate brachytherapy (LDR-BT) for prostate cancer.
We enrolled patients who underwent LDR-BT (LDR-BT alone [n = 540] or LDR-BT plus external beam radiation therapy [n = 428]) and RARP (n = 142). QOL was evaluated using the International Prostate Symptom Score, Expanded Prostate Cancer Index Composite (EPIC), Sexual Health Inventory for Men (SHIM), and 8-item Short Form (SF-8) health survey. The two groups were compared using propensity score matching analysis.
At 24 months after treatment, the number of patients with worsened urinary QOL in the urinary domain of EPIC compared with baseline was 78/111 (70%) and 63/137 (46%) in the RARP and LDR-BT groups, respectively (p < 0.001). In the urinary incontinence and function domain, this number was higher in the RARP group versus the LDR-BT group. However, in the urinary irritative/obstructive domain, the number of patients with improved urinary QOL at 24 months compared with baseline was 18/111 (16%) and 9/137 (7%), respectively (p = 0.01). Regarding the SHIM score, sexual domain of EPIC, and mental component summary of SF-8, there were more number of patients with worsened QOL in the RARP group than in the LDR-BT group. In the EPIC bowel domain, the number of patients with worsened QOL was lower in the RARP group versus the LDR-BT group.
The differences in QOL observed between patients treated with RARP and LDR-BT could assist in treatment selection for prostate cancer.
The Prostate. 2023 Mar 06 [Epub ahead of print]
Yasushi Nakai, Nobumichi Tanaka, Isao Asakawa, Shunta Hori, Makito Miyake, Kaori Yamaki, Satoshi Anai, Kazumasa Torimoto, Takeshi Inoue, Masatoshi Hasegawa, Kiyohide Fujimoto
Department of Urology, Nara Medical University, Kashihara, Nara, Japan., Department of Prostate Brachytherapy, Nara Medical University, Kashihara, Nara, Japan., Department of Radiation Oncology, Nara Medical University, Kashihara, Nara, Japan., Department of Urology, Nara Prefecture General Medical Center, Nara, Japan.