Prospective and longitudinal patient self-assessment of health-related quality of life following radical perineal prostatectomy.
OBJECTIVE
We provide a comprehensive, longitudinal assessment of health related quality of life (HRQOL) following radical perineal prostatectomy (RPP).


METHODS
We report the results of a prospective cohort study of 109 patients with at least 3 months of followup who underwent RPP between January 2001 and July 2003. A validated patient self-assessment questionnaire, the Expanded Prostate Cancer Index Composite, was administered preoperatively, and 1, 3, 6, 9, 12 and 18 months postoperatively. Mean domain specific HRQOL scores were calculated as well as the proportion of patients achieving an individual baseline by each interval. The Cox proportional hazards model was used to identify predictors of a successful return to baseline of disease specific HRQOL scores.


RESULTS
HRQOL scores were lowest 1 month postoperatively and they increased with time. By 6 months a majority of patients had recovered baseline summary scores in urinary (65.1%), bowel (93.6%) and hormonal (91.7%) domains at a median of 5.8 (95% CI 3.6 to 6.2), 1.3 (95% CI 1.1 to 1.5) and 1.3 (95% CI 1.2 to 1.8) months, respectively. One in 4 patients recovered the sexual summary score by 18 months. Significant independent predictors for the recovery of domain summary scores were younger age in urinary (p = 0.001), individual surgeon in bowel (p = 0.022), and older age (p = 0.017) and absent medical comorbidities (p = 0.012) in hormonal domains.


CONCLUSIONS
A majority of patients undergoing RRP experience an early recovery of individual urinary, bowel and hormonal HRQOL. Future studies should establish the benefit of bilateral nerve sparing RPP on the recovery of sexual domain HRQOL.
Yang
Benjamin K
BK
Division of Urology, Department of Surgery and Cancer Center Biostatistics, Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina 27710, USA.
Young
Matthew D
MD
Calingaert
Brian
B
Albala
David M
DM
Vieweg
Johannes
J
Murphy
Brian C
BC
Dahm
Philipp
P
D000368:Aged; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery; D011788:Quality of Life
D017430:Prostate-Specific Antigen