title: Health related quality of life and direct medical care cost in newly diagnosed younger men with prostate cancer.
abstract: OBJECTIVE
  We evaluated health related quality of life (HRQOL) and the direct medical care cost (DMC) in young men receiving radical prostatectomy.
  
  
  METHODS
  In this prospective cohort study, 40 newly diagnosed patients with prostate cancer (PCa) who were younger than 65 years were matched with 40 cancer-free men. Participants completed the Medical Outcome Study Short Form and UCLA-PCa Index surveys prior to treatment, and at 3, 6, 12 and 24-month followup. Cost data were obtained from a hospital based administrative database and clinical data were obtained via structured medical chart review. Demographics and HRQOL were compared using the t, Fisher exact and chi-square tests. The Wilcoxon and log-T tests were used to compare DMC. Multivariate regression models were used to assess the incremental cost of PCa and predictors of 24-month prostate specific HRQOL.
  
  
  RESULTS
  Patients with PCa had a mean annual DMC of 4,160 dollars for the treatment year with a mean length of stay of 3.5 days. They had 3-fold higher DMC than controls. At 12 months, generic HRQOL values were similar to baseline values. Sexual function showed trends toward improvement 6 months after surgery. Urinary function improved significantly by 6 months, although it decreased thereafter. Bowel function and bother returned to baseline values by 3 months. On multivariate regression marital status was a significant predictor of 5 domains of prostate specific HRQOL at 24 months.
  
  
  CONCLUSIONS
  Patients with PCa reported weaker sexual function, urinary function and sexual bother at 2 years after treatment compared with their baseline values. There exists an opportunity for improving prostate specific HRQOL in men with early stage PCa.
authors.affiliation: Department of Medicine, Leonard Davis Institute of Health Economics, Philadelphia, Pennsylvania, USA. jravi@mail.med.upenn.edu
authors.forename: Ravishankar
authors.initials: R
authors.lastname: Jayadevappa
authors.forename: Bernard S
authors.initials: BS
authors.lastname: Bloom
authors.forename: Sumedha
authors.initials: S
authors.lastname: Chhatre
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Fomberstein
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011468:Prostatectomy / Q000191:economics* / Q000523:psychology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012725:Sexual Behavior