title: Long-term health-related quality of life after primary treatment for localized prostate cancer: results from the CaPSURE registry.
abstract: BACKGROUND
  Few studies have reported on late declines and long-term health-related quality of life (HRQOL) after prostate cancer (PCa) treatment.
  
  
  OBJECTIVE
  We assessed long-term HRQOL following various treatments for localized PCa.
  
  
  METHODS
  This cohort study of HRQOL up to 10 yr after treatment used a prospectively accrued, nationwide PCa registry that collects longitudinal patient-reported HRQOL.
  
  
  METHODS
  Various primary treatments for localized PCa.
  
  
  METHODS
  The Medical Outcomes Studies 36-item Short Form and the University of California, Los Angeles, Prostate Cancer Index characterized physical function, mental health, and sexual, urinary, and bowel function and bother. Repeated measures mixed-model analysis assessed change in HRQOL by treatment over time, and logistic regression was used to measure the likelihood of a clinically significant decline in HRQOL.
  
  
  CONCLUSIONS
  Among 3294 men, 1139 (34%) underwent nerve-sparing radical prostatectomy (NSRP), 860 (26%) underwent non-NSRP, 684 (21%) underwent brachytherapy, 386 (12%) underwent external beam radiotherapy, 161 (5%) underwent primary androgen deprivation therapy, and 64 (2%) pursued watchful waiting/active surveillance. Median follow-up was 74 mo (interquartile range: 50-102). Most treatments resulted in early declines in HRQOL, with some recovery over the next 1-2 yr and a plateau in scores thereafter. Surgery had the largest impact on sexual function and bother and on urinary function, radiation had the strongest effect on bowel function, and androgen deprivation therapy had the strongest effect on physical function. The main limitation was attrition among the cohort.
  
  
  CONCLUSIONS
  Although most men experience initial declines in HRQOL in the first 2 yr after treatment, there is little change from 3 to 10 yr and most differences between treatments attenuated over time.
  
  
  RESULTS
  Various treatments for prostate cancer result in a distinct constellation of adverse effects on health-related quality of life, which may have a long-term impact. These findings are helpful regarding shared decision making over choice of primary treatment.
authors.affiliation: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Sanoj
authors.initials: S
authors.lastname: Punnen
authors.affiliation: University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Cowan
authors.affiliation: University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: June M
authors.initials: JM
authors.lastname: Chan
authors.affiliation: University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Carroll
authors.affiliation: University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA. Electronic address: mcooperberg@urology.ucsf.edu.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Cooperberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D001918:Brachytherapy / Q000009:adverse effects / Q000523:psychology; D016009:Chi-Square Distribution; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D057832:Watchful Waiting
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal
keywords: HRQOL; Prostate cancer; Treatment