title: Impact of comorbidity on health-related quality of life in men undergoing radical prostatectomy: data from CaPSURE.
abstract: OBJECTIVE
  Comorbidity is one of many factors that may affect health-related quality of life (HRQOL) in men with prostate cancer. We hypothesized that the number and type of comorbidities negatively affect HRQOL in men undergoing radical prostatectomy.
  
  
  METHODS
  We reviewed HRQOL outcomes before and up to 2 years after radical prostatectomy for men with localized prostate cancer in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE), a longitudinal disease registry. This analysis focused on 856 men who completed a pretreatment survey and at least one posttreatment survey. HRQOL was assessed using the University of California, Los Angeles, Prostate Cancer Index (six subscales) and the Medical Outcomes Study 36-Item Short Form questionnaire (eight subscales and two summary scales). The associations between HRQOL and the number and type of comorbidities were analyzed using repeated measures during a 2-year follow-up period.
  
  
  RESULTS
  Preoperatively, men with no comorbidities had greater HRQOL scores than did men with comorbidities for physical health and disease-specific measures, but not for mental health measures. Only sexual function and the physical component summary scores showed a significant interaction between the number of comorbidities and time (P < 0.01 and P = 0.03, respectively). Significant interactions with time were observed for other urinary conditions, gastrointestinal disease, heart disease, and hypertension on at least one HRQOL domain.
  
  
  CONCLUSIONS
  Men with comorbidities had worse HRQOL scores than men without comorbidities, both before and after radical prostatectomy. However, with two exceptions, the scores declined at similar rates after surgery. Specific comorbidities also had an association with certain HRQOL domains. Therefore, during preoperative counseling, clinicians should consider a patient's number and type of comorbidities.
authors.affiliation: Department of Urology, Urology Outcomes Research Group, Comprehensive Cancer Center, University of California, School of Medicine, San Francisco, California 94143-1798, USA.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Arredondo
authors.forename: Eric P
authors.initials: EP
authors.lastname: Elkin
authors.forename: Paige L
authors.initials: PL
authors.lastname: Marr
authors.forename: David M
authors.initials: DM
authors.lastname: Latini
authors.forename: Janeen
authors.initials: J
authors.lastname: DuChane
authors.forename: Mark S
authors.initials: MS
authors.lastname: Litwin
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
mesh_terms: D000368:Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000150:complications* / Q000601:surgery*; D011788:Quality of Life