title: Predictors of patient reported outcomes and cost of care in younger men with newly diagnosed prostate cancer.
abstract: BACKGROUND
  The proportion of younger men (<65 years) diagnosed with prostate cancer (PCa) has increased significantly. We sought to analyze the association between race/ethnicity, biochemical recurrence risk and outcomes in younger men with PCa.
  
  
  METHODS
  In this prospective cohort study, we recruited 318 younger men with newly diagnosed PCa. Participants completed generic and prostate-specific Health Related Quality of Life (HRQoL), out-of-pocket cost and satisfaction with care surveys at baseline and at 3, 6, 12, and 24 months of follow-up. Health resource utilization and cost data were obtained from the hospital based administrative databases. We compared time to return to baseline (RTB) of HRQoL scores across groups. Survival curves were used to compare mean time to RTB across groups. Linear mixed effects (LMEs) and generalized linear (GLM) models were used to analyze the association of race/ethnicity and biochemical recurrence groups with outcomes.
  
  
  RESULTS
  African Americans reported lower generic and prostate-specific HRQoL scores at diagnosis and required more time to RTB values for generic HRQoL. The results of LME models showed that low risk of biochemical recurrence was associated with better physical function, vitality, mental health, and general health. For prostate-specific HRQoL items, low risk of biochemical recurrence was associated with impaired urinary function and better bowel function and bowel bother. GLM model showed that treatment, hospital type and comorbidity were associated with cost.
  
  
  CONCLUSIONS
  Biochemical recurrence risk and treatment groups, not ethnicity, were associated poorer post-treatment outcomes. This information is important in planning for and communicating with patients about post-treatment care.
authors.affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-2676, USA. jravi@mail.med.upenn.edu
authors.forename: Ravishankar
authors.initials: R
authors.lastname: Jayadevappa
authors.forename: Sumedha
authors.initials: S
authors.lastname: Chhatre
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Wein
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz