The impact of androgen deprivation therapy on health related quality of life in asymptomatic men with lymph node positive prostate cancer.
OBJECTIVE
To evaluate the impact of androgen deprivation on health related quality of life (HRQOL) in patients with asymptomatic lymph node positive prostatic carcinoma (LPPC).


METHODS
HRQOL domains were measured, using standard instruments in 91 patients with histologically proven LPPC. Most patients were randomized for immediate or deferred hormonal treatment until progression was observed. For analyses concerning the time to progression and survival the Kaplan-Meier method was used.


RESULTS
Patients treated with androgen deprivation showed a significantly worse sexual, emotional, and physical function, experienced more hot flushes and a worse overall HRQOL, compared with patients receiving no therapy. Time to progression was significantly shorter in the deferred treated patients in comparison with the immediately treated patients (33 vs. 62 months, p<0.001). No significant differences were found with respect to the duration of survival.


CONCLUSIONS
Hormonally treated patients with asymptomatic LPPC have a worse HRQOL compared with patients receiving no therapy. The duration of survival was similar, whether patients received immediate or deferred hormonal treatment. Nowadays, with patients' preferences playing an increasingly important role in therapeutic decision making, physicians should be aware of this negative impact and ought to inform the patients on this.
van Andel
G
G
Department of Urology, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Kurth
K H
KH
D000342:Affective Symptoms / Q000209:etiology; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005221:Fatigue / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014555:Urination Disorders / Q000209:etiology
D000726:Androgen Antagonists