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Minerva Urology and Nephrology 2022 February;74(1):11-20

DOI: 10.23736/S2724-6051.20.04032-1


language: English

Health-related quality of life 24 months after prostate cancer diagnosis: an update from the Pros-IT CNR prospective observational study

Carlotta PALUMBO 1, Alessio BRUNI 2, Alessandro ANTONELLI 3, Walter ARTIBANI 4, Pierfrancesco BASSI 5, Filippo BERTONI 6, Paolo BORGHETTI 7, Sergio BRACARDA 8, Alessandro CICCHETTI 9, Renzo CORVÒ 10, Mauro GACCI 11, Gianluca INGROSSO 12, Stefano M. MAGRINI 7, Marco MARUZZO 13, Vincenzo MIRONE 14, Rodolfo MONTIRONI 15, Giovanni MUTO 16, Marianna NOALE 17 , Angelo PORRECA 18, Elvio RUSSI 19, Luca TRIGGIANI 7, Andrea TUBARO 20, Riccardo VALDAGNI 9, Stefania MAGGI 17, Giario N. CONTI 21, Pros-IT CNR Study Group 

1 Department of Urology, Maggiore della Carità Hospital, Novara, Italy; 2 Unit of Radiotherapy, University Hospital of Modena, Modena, Italy; 3 Department of Urology, University of Verona, Verona, Italy; 4 Italian Society of Urology, Rome, Italy; 5 Department of Urology, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy; 6 Prostate Group of the Italian Association for Radiation Oncology (AIRO), Milan, Italy; 7 Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy; 8 Azienda Ospedaliera S. Maria, Terni, Italy; 9 Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; 10 Department of Radiation Oncology, IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy; 11 Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; 12 Section of Radiation Oncology, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy; 13 Medical Oncology Unit 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy; 14 Department of Urology, University of Naples Federico II, Naples, Italy; 15 Section of Pathological Anatomy, School of Medicine, United Hospitals, Polytechnic University of the Marche Region, Ancona, Italy; 16 Department of Urology, Humanitas Gradenigo University Hospital, Turin, Italy; 17 National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy; 18 Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy; 19 Department of Radiotherapy, S. Croce e Carle Teaching Hospital, Cuneo, Italy; 20 Unit of Urology, Sant’Andrea Hospital, La Sapienza University of Rome, Rome, Italy; 21 Department of Urology, Sant’Anna Hospital, Como, Italy

BACKGROUND: This study analyzes patient health-related quality of life (QoL) 24-month after prostate cancer (PCa) diagnosis within the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study.
METHODS: Pros-IT CNR is an ongoing, longitudinal and observational study, considering a convenience sample of patients enrolled at PCa diagnosis and followed at 6, 12, 24, 36, 48 and 60 months from the diagnosis. Patients were grouped according to the treatment received: nerve sparing radical prostatectomy (NSRP), non-nerve sparing radical prostatectomy (NNSRP), radiotherapy (RT), RT plus androgen deprivation (RT plus ADT) and active surveillance (AS). QoL was measured through the Italian versions of SF-12 and UCLA-PCI questionnaires at diagnosis and at 6-12 and 24-month. The minimal clinically important difference (MCID) was defined as half a standard deviation of the baseline domain.
RESULTS: Overall, 1537 patients were included in the study. The decline in urinary function exceeded the MCID at each timepoint only in the NSRP and NNSRP groups (at 24 months -14.7, P<0.001 and -19.7, P<0.001, respectively). The decline in bowel function exceeded the MCID only in the RT (-9.1, P=0.02) and RT plus ADT groups at 12 months (-10.3, P=0.001); after 24 months, most patients seem to recover their bowel complaints. The decline in sexual function exceeded the MCID at each timepoint in the NNSRP, NSRP and RT plus ADT groups (at 6 months -28.7, P<0.001, -37.8, P<0.001, -20.4, P<0.001, respectively).
CONCLUSIONS: Although all the treatments were relatively well-tolerated over the 24 month period following PCa diagnosis, each had a different impact on QoL.

KEY WORDS: Prostatic neoplasms; Quality of life; Patient reported outcomes measure; Prostatectomy; Radiotherapy; Watchful waiting

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