title: Health-related quality of life after radical prostatectomy depends on patient's age but not on comorbidities.
abstract: OBJECTIVE
  Localized prostate cancer affects younger and healthy patients as well as older patients with comorbidities. The purpose of this study was to evaluate the effect of age and comorbidities on the quality-of-life (QoL) course before and after radical retropubic prostatectomy.
  
  
  METHODS
  Overall, 374 patients with localized prostate cancer scheduled for radical prostatectomy were prospectively included. The QoL questionnaire QLQ-C30 (European Organisation for Research and Treatment of Cancer) was completed 1 day before surgery and 3, 6, 9, and 12 months after radical prostatectomy. Sexual and urinary functions were not assessed in this analysis. Subgroups according to age at diagnosis (≤60,>60 to≤70, and>70y) and comorbidities (Charlson scores≤2 and ≥3) were defined. Subgroups were compared using the Wilcoxon-Mann-Whitney test, whereas changes in a group over time were analyzed with the Wilcoxon signed rank test.
  
  
  RESULTS
  In all patient groups, no change was found 12 months after surgery compared with preoperative values in global health as well as functioning (role, physical, cognitive, and social). Emotional functioning improved significantly after surgery compared with preoperative functioning. Older patients (>70y) had better emotional and social functioning compared with younger patients (≤60y). The other scores were comparable between older and younger patients. Global health and physical, role, cognitive, and social functioning were independent of the number of comorbidities, although patients with a Charlson score≥3 did worse regarding fatigue and dyspnoe.
  
  
  CONCLUSIONS
  The QoL of older patients or patients with multiple comorbidities is not negatively influenced by radical prostatectomy. This should be considered when discussing the indication for prostatectomy in older or comorbid patients.
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. Electronic address: kathleen.herkommer@lrz.tum.de.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Herkommer
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Sebastian C
authors.initials: SC
authors.lastname: Schmid
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Helga
authors.initials: H
authors.lastname: Schulwitz
authors.affiliation: Department of Psychosomatic and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Dinkel
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Tobiasz
authors.initials: T
authors.lastname: Klorek
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hofer
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Ehrl
authors.affiliation: Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Blaser
authors.affiliation: Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Jürgen E
authors.initials: JE
authors.lastname: Gschwend
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Kron
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life
keywords: Charlson index; Prostate cancer; QLQ-C30; Quality of life; Radical prostatectomy