title: Prospective Quality of Life in Men Choosing Active Surveillance Compared to Those Biopsied but not Diagnosed with Prostate Cancer.
abstract: Active surveillance is an important alternative to definitive therapy for men with low risk prostate cancer. However, the impact of active surveillance on health related quality of life compared to that in men without cancer remains unknown. In this study we evaluated health related quality of life outcomes in men on active surveillance compared to men followed after negative prostate needle biopsy.
  
  
  
  A prospective study was conducted on men who were enrolled into the Center for Prostate Disease Research Multicenter National Database and underwent prostate needle biopsy for suspicion of prostate cancer between 2007 and 2014. Health related quality of life was assessed at biopsy (baseline) and annually for up to 3 years using SF-36 and EPIC questionnaires. Health related quality of life scores were modeled using generalized estimating equations, adjusting for baseline health related quality of life, and demographic and clinical characteristics.
  
  
  
  Of the 1,204 men who met the initial eligibility criteria 420 had a negative prostate needle biopsy (noncancer comparison group). Among the 411 men diagnosed with low risk prostate cancer 89 were on active surveillance. Longitudinal analysis revealed that for most health related quality of life subscales there were no significant differences between the groups in adjusted health related quality of life score trends over time.
  
  
  
  In this study most health related quality of life outcomes in patients with low risk prostate cancer on active surveillance did not differ significantly from those of men without prostate cancer. A comparison group of men with a similar risk of prostate cancer detection is critical to clarify the psychological and physical impact of active surveillance.
authors.affiliation: Virginia Mason, Seattle, Washington.
authors.forename: Khanh N
authors.initials: KN
authors.lastname: Pham
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Electronic address: jcullen@cpdr.org.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cullen
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Hurwitz
authors.affiliation: Virginia Mason, Seattle, Washington.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Wolff
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Levie
authors.affiliation: Center for Biomedical Statistics, Seattle, Washington; Institute of Translational Health Sciences, Seattle, Washington.
authors.forename: Katherine
authors.initials: K
authors.lastname: Odem-Davis
authors.affiliation: Virginia Mason, Seattle, Washington.
authors.forename: John S
authors.initials: JS
authors.lastname: Banerji
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Urology Service, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Inger L
authors.initials: IL
authors.lastname: Rosner
authors.affiliation: Madigan Army Medical Center, Tacoma, Washington; Center for Prostate Disease Research, Department of Defense, Rockville, Maryland.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Brand
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Naval Medical Center San Diego, San Diego, California.
authors.forename: James O
authors.initials: JO
authors.lastname: L'Esperance
authors.affiliation: Center for Prostate Disease Research, Department of Defense, Rockville, Maryland; Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Sterbis
authors.affiliation: Virginia Mason, Seattle, Washington; Center for Prostate Disease Research, Department of Defense, Rockville, Maryland.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Porter
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D016208:Databases, Factual; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D011788:Quality of Life; D057832:Watchful Waiting
keywords: image-guided biopsy; prostatic neoplasms; quality of life; survival rate; watchful waiting