Prospective Quality of Life in Men Choosing Active Surveillance Compared to Those Biopsied but not Diagnosed with Prostate Cancer.

Active surveillance (AS) is an important alternative to definitive therapy for men with low-risk prostate cancer (PCa). However, the impact of AS on health-related quality of life (HRQoL) when compared to men without cancer remains unknown. This study evaluated HRQoL outcomes in men on AS compared to men followed after negative prostate needle biopsy (PNB).

A prospective study was conducted on men enrolled into the Center for Prostate Disease Research (CPDR) multi-center national database and undergoing PNB for suspicion of PCa between 2007 and 2014. HRQoL was assessed at time of biopsy (baseline) and annually for up to three years using SF-36 and EPIC questionnaires. HRQoL scores were modeled using generalized estimating equations, adjusting for baseline HRQoL, demographic and clinical characteristics.

Of the 1,204 men who met initial eligibility criteria, 420 had a negative PNB (non-cancer comparison group). Among the 411 men diagnosed with low-risk PCa, 89 were managed with AS. Longitudinal analysis revealed that for most HRQoL subscales, there were no significant differences between groups in adjusted HRQoL score trends over time.

In this study, most HRQoL outcomes in patients with low-risk PCa managed with AS do not differ significantly from men without PCa. A comparison group of men with a similar risk of PCa detection is critical for clarifying the psychological and physical impact of AS.

The Journal of urology. 2016 Mar 11 [Epub ahead of print]

Khanh N Pham, Jennifer Cullen, Lauren M Hurwitz, Erika M Wolff, Katherine E Levie, Katherine Odem-Davis, John S Banerji, Inger L Rosner, Timothy C Brand, James O L'Esperance, Joseph R Sterbis, Christopher R Porter

Virginia Mason; Seattle, WA., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine; Uniformed Services University of the Health Sciences, Department of Surgery; Bethesda, MD. Electronic address: ., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine., Virginia Mason; Seattle, WA., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Henry M. Jackson Foundation for the Advancement of Military Medicine., Center for Biomedical Statistics, Seattle, WA; Institute of Translational Health Sciences, Seattle, WA., Virginia Mason; Seattle, WA., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Walter Reed National Military Medical Center, Urology Service; Bethesda, MD., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Madigan Army Medical Center; Tacoma, WA., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Naval Medical Center San Diego; San Diego, CA., Center for Prostate Disease Research, Department of Defense; Rockville, MD; Tripler Army Medical Center; Honolulu, HI., Virginia Mason; Seattle, WA; Center for Prostate Disease Research, Department of Defense; Rockville, MD.