Prospective quality of life in men choosing open vs. robotic radical prostatectomy: long-term results from a racially diverse multi-institutional database.

Autor: Kord E; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA. Eyalkord@gmail.com., Jung N; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA., Boehm B; Walter Reed National Military Medical Center, Bethesda, MD, USA., Conti G; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; American Urogynecologic Society, Silver Spring, MD, USA., Kuo HC; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA., Frankel J; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA.; Washington St. Louis University, St. Louis, MO, USA., Flores J; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA., Levie K; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA.; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Syapse, Inc, San Francisco, CA, USA., Ho O; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA., Elsamanoudi S; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA., Jiang J; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA., Stroup SP; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Naval Medical Center, San Diego, CA, USA., Musser J; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Tripler Army Medical Center, Honolulu, HI, USA., Ernest A; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Brooke Army Medical Center, Fort Sam Houston, TX, USA., Speir R; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.; Madigan Army Medical Center, Tacoma, WA, USA., Chesnut G; Walter Reed National Military Medical Center, Bethesda, MD, USA.; Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA., Tausch TJ; Walter Reed National Military Medical Center, Bethesda, MD, USA., Porter C; Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2022 Jun; Vol. 40 (6), pp. 1427-1436. Date of Electronic Publication: 2022 Mar 12.
DOI: 10.1007/s00345-022-03975-8
Abstrakt: Purpose: To compare 5-year health-related quality of life (HRQoL) outcomes between prostate cancer (CaP) patients who underwent robotic-assisted laparoscopic radical prostatectomy (RALP) versus open radical retropubic prostatectomy (RRP) and assess for racial disparities between Caucasian American (CA) and African American (AA) men undergoing surgery.
Methods: A prospective cohort study of HRQoL data was conducted on patients diagnosed with CaP from 2007 to 2017 and enrolled in the Center for Prostate Disease Research (CPDR) Multicenter National Database. Using the EPIC and SF-36 instruments, changes in urinary, sexual, bowel, and hormonal domains, as well as physical and mental component summary scores were compared across surgery type (RALP versus RRP) at pre-treatment ("baseline"), and annually for 5 years. We further compared HRQoL outcomes in CA and AA men undergoing surgery. Longitudinal HRQoL patterns were modeled using generalized estimating equations (GEE), adjusting for baseline HRQoL and other characteristics.
Results: 448 CaP patients (22% AA) met study inclusion criteria, 66% underwent RALP and 34% underwent RRP. At baseline, HRQoL domains were comparable across treatment group (RALP vs. RRP). In the adjusted low-risk cohort, there were only three time points that met a statistically significant HRQoL difference in EPIC scores between RALP and RRP. Urinary function score during year 4 of follow-up showed a 7.5 (95% CI 3.1-11.9, P = 0.01) points difference in favor of RRP. Bowel bother scores favored RRP in year 1 with a difference of 3.1 (95% CI 0.7-5.4, P = 0.04) points, and in year 5 with a difference of 3.8 (95% CI 1.1-6.4, P = 0.03) points. In the intermediate/high-risk cohort, there were no statistically significant differences in any of the domain scores between RALP and RRP during follow-up.
Conclusions: The robotic and open approach to radical prostatectomy led to comparable HRQoL outcomes at a follow-up length of 60 months. No HRQoL racial disparities were found between AA and CA men during long-term follow-up.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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