The effect of comorbidity and socioeconomic status on sexual and urinary function and on general health-related quality of life in men treated with radical prostatectomy for localized prostate cancer.
BACKGROUND
Different treatments for localized prostate cancer (PCa) may be associated with similar overall survival but may demonstrate important differences in health-related quality of life (HRQOL). Therefore, valid interpretation of cancer control outcomes requires adjustment for HRQOL.


OBJECTIVE
To assess the effect of comorbidity and socioeconomic status (SES) on sexual and urinary function as well as general HRQOL in men treated with radical prostatectomy (RP) for PCa.


METHODS
We sent a self-addressed mail survey, composed of the research and development short form 36-item health survey, the PCa-specific University of California at Los Angeles (UCLA) Prostate Cancer Index (PCI), as well as a battery of items addressing SES and lifetime prevalence of comorbidity, to 4,546 men treated with RP in Quebec between 1988 and 1996.


METHODS
The association between comorbidity, SES, and HRQOL was tested and quantified using univariable and multivariable linear regression models.


RESULTS
Survey responses from 2,415 participants demonstrated that comorbidity and SES are strongly related to sexual, urinary, and general HRQOL in univariable and multivariable analyses. In multivariable models, the presence of comorbid conditions was associated with significantly worse HRQOL, as evidenced by lower scale scores by as much as 17/100 points in general domains, and by as much as 10/100 points in PCa-specific domains. Favorable SES characteristics were related to higher general (up to 9/100 points) and higher PCa-specific (up to 8/100 points) HRQOL scale scores.


CONCLUSIONS
Comorbidity and SES are strongly associated with sexual, urinary and general HRQOL.
Karakiewicz
Pierre I
PI
University of Montreal Health Center (CHUM)-Cancer Prognostics and Health Outcomes Unit, Montreal, Canada;. Electronic address: karakiewicz@umontreal.ca.
Bhojani
Naeem
N
University of Montreal-Urology, Montreal, Canada.
Neugut
Alfred
A
Columbia University-The Departments of Medicine and Epidemiology, New York, NY, USA.
Shariat
Shahrokh F
SF
University of Texas Southwestern-Urology, Dallas, TX, USA.
Jeldres
Claudio
C
University of Montreal-Urology, Montreal, Canada.
Graefen
Markus
M
University of Hamburg, Hamburg, Germany.
Perrotte
Paul
P
University of Montreal Health Center (CHUM)-Cancer Prognostics and Health Outcomes Unit, Montreal, Canada.
Peloquin
Francois
F
University of Montreal-Urology, Montreal, Canada.
Kattan
Michael W
MW
Cleveland Clinic Foundation-Department of Biostatistics and Epidemiology, Cleveland, OH, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D011788:Quality of Life; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology*