title: Health-related quality of life results in pathologic stage C prostate cancer from a Southwest Oncology Group trial comparing radical prostatectomy alone with radical prostatectomy plus radiation therapy.
abstract: OBJECTIVE
  To compare short- and long-term effects of adjuvant treatment versus observation after surgery on health-related quality of life (HRQL) of prostate cancer patients.
  
  
  METHODS
  The Southwest Oncology Group (SWOG) intergroup trial compared radical prostatectomy (RP) plus observation versus RP plus adjuvant radiation therapy (RT). Two-hundred seventeen of 425 therapeutic trial patients were eligible and registered to the HRQL study. Patients completed the SWOG Quality of Life Questionnaire (emotional, physical, social, and role function; general symptom status; treatment/disease-specific symptoms; and global HRQL [GHRQL]) at baseline, 6 weeks, 6 months, and annually for 5 years. Prespecified outcomes were three genitourinary symptoms (bowel function tenderness, frequent urination, and erectile dysfunction [ED]) and measures of physical and emotional function. Adjustments were made for the baseline score.
  
  
  RESULTS
  Patients receiving adjuvant RT reported worse bowel function (through approximately 2 years) and worse urinary function. There were no statistically significant differences for ED. GHRQL was initially worse for the RP+RT arm but improved over time and was better at the end of the period than the GHRQL reported for RP alone (treatment arm x time interaction, P = .0004). Symptom distress was significantly worse for the RP+RT arm compared with the RP alone arm, but the treatment arms did not differ with respect to other general measures of HRQL.
  
  
  CONCLUSIONS
  The addition of RT to surgery resulted in more frequent urination, as well as early report of more bowel dysfunction, although bowel function differences disappeared over the 5-year period. The addition of RT did not negatively impact ED.
authors.affiliation: Southwest Oncology Group Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
authors.forename: Carol M
authors.initials: CM
authors.lastname: Moinpour
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Hayden
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Unger
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.forename: Mary W
authors.initials: MW
authors.lastname: Redman
authors.forename: Edith D
authors.initials: ED
authors.lastname: Canby-Hagino
authors.forename: Betsy A
authors.initials: BA
authors.lastname: Higgins
authors.forename: Jerry W
authors.initials: JW
authors.lastname: Sullivan
authors.forename: Dianne
authors.initials: D
authors.lastname: Lemmon
authors.forename: Sheila
authors.initials: S
authors.lastname: Breslin
authors.forename: E David
authors.initials: ED
authors.lastname: Crawford
authors.lastname: Southwest Oncology Group
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome