The impact of psychiatric pathology on the prognosis and survival of men with prostate cancer undergoing radical prostatectomy.

Autor: Cózar-Ortiz JD; Servicio de Psiquiatría, Hospital Universitario Gómez Ulla, Madrid, Spain., Cózar-Olmo JM; Departamento de Cirugía, Universidad de Granada, Granada, Spain., Álvarez-Ossorio-Fernández JL; Servicio de Urología, Hospital Universitario Puerta del Mar, Cádiz, Spain., Esteban-Fuertes M; Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, Spain., Chantada-Abal V; Servicio de Urología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain., Valverde-Martínez LS; Servicio de Urología, Complejo Asistencial de Ávila, Ávila, Spain., Márquez-Sánchez MT; Departamento de Cirugía, Universidad de Salamanca, Salamanca, Spain. Electronic address: magalymarquez77@gmail.com., Padilla-Fernández BY; Departamento de Cirugía, Universidad de La Laguna, Tenerife, Islas Canarias, Spain., Lorenzo-Gómez MF; Departamento de Cirugía, Universidad de Salamanca, Salamanca, Spain; Servicio de Urología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Actas urologicas espanolas [Actas Urol Esp (Engl Ed)] 2022 Dec; Vol. 46 (10), pp. 646-652. Date of Electronic Publication: 2022 Oct 20.
DOI: 10.1016/j.acuroe.2022.10.003
Abstrakt: Introduction and Objective: Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with prostate cancer undergoing RP and identified the effects of psychiatric diagnoses on their survival and prognosis.
Material and Methods: Retrospective multicenter observational study including 1078 men treated with RP for organ-confined prostate cancer. Groups: GP: patients with psychiatric pathology prior to RP; GNP: patients without psychiatric pathology prior to RP. Urological, oncological and psychiatric variables, descriptive statistics and multivariate analysis were included.
Results: 37.94% of patients presented a psychiatric diagnosis. Adjuvant radiotherapy was required in 27.83% and hormone therapy in 23.38%; being more frequent in GP. Cancer-specific survival was higher in GNP. Anxiety, depression, insomnia, smoking, psychosis and alcoholism were the most frequent. Low TNM and low presence of LUTS and SUI increased the probability of absence of psychiatric pathology. Fatigue, erectile dysfunction and cognitive impairment after RP with RT and/or HT were higher in GP. Older age and higher PSA at diagnosis increased the relative risk of psychiatric pathology and worse outcome. The most frequently related factors were RP, PSA, age and survival time.
Conclusions: Psychiatric pathology is present in patients undergoing radical prostatectomy for prostate cancer, with a high impact on survival and prognostic outcomes.
(Copyright © 2022 AEU. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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