title: Effect of perioperative complications and functional outcomes on health-related quality of life after radical prostatectomy.
abstract: OBJECTIVE
  Radical prostatectomy is a commonly performed procedure with perioperative complication rates of 30 % using standardized reporting methodology. We aim to determine whether perioperative complications and functional outcomes impact quality of life 1 year after surgical treatment.
  
  
  METHODS
  Quality of life, functional and oncological outcomes were assessed in patients who underwent open retropubic radical prostatectomy at a single academic institution between 2003 and 2009, preoperatively and 1 year after surgery using the EORTC QLQ-C30, the IIEF-5 and an institutional questionnaire. Perioperative complications were recorded using the Clavien-Dindo classification. Patients without complications were compared to patients with any, low- or high-grade complications. The global health score domain of the EORTC QLQ-C30 is reported for various oncological and functional outcomes and contrasted to stratified categories of complications and functional outcomes.
  
  
  RESULTS
  A full dataset was available for 29.5 % (n = 856) of all patients. The overall complication rate was 27.5 % (235/856). A total of 307 complications were recorded of whom 88.9 % (273/307) were low grade. In this study, population global health perception did not decline after surgery (70.5 ± 21.2 vs. 74.4 ± 19.7; p < 0.0001). Complications showed only statistical but no clinical meaningful influence on global health perception as well as on functional and symptom scales. Patients who met combined outcome criteria experienced the best postoperative global health score (86.0 ± 13.1 and 86.0 ± 14.2).
  
  
  CONCLUSIONS
  Perioperative complications and functional outcomes have a measurable impact on quality of life 1 year following surgery. While perioperative complications have a statistical effect, functional outcomes showed a clinically more profound effect on postoperative global health perception.
authors.affiliation: Department of Urology and Neuro-Urology, Marien Hospital Herne, Ruhr-University Bochum, Widumerstrasse 8, 44627, Herne, Germany, bjoern.loeppenberg@marienhospital-herne.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Löppenberg
authors.forename: Christian
authors.initials: C
authors.lastname: von Bodman
authors.forename: Marko
authors.initials: M
authors.lastname: Brock
authors.forename: Florian
authors.initials: F
authors.lastname: Roghmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Noldus
authors.forename: Rein Jüri
authors.initials: RJ
authors.lastname: Palisaar
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011468:Prostatectomy / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome