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Minerva Urologica e Nefrologica 2021 Jan 13

DOI: 10.23736/S0393-2249.20.04032-1


language: English

Health-related quality of life 24-month 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, Pier Francesco 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, for the Pros-IT CNR Study Group

1 Department of Urology, Maggiore della Carità Hospital, Novara, Italy; 2 Radiotherapy Unit, University Hospital of Modena, Modena, Italy; 3 Department of Urology, University of Verona, Verona, Italy; 4 Secretary General of Italian Society of Urology, Italy; 5 Department of Urology, Catholic University of Rome, Policlinico Gemelli, Rome, Italy; 6 Prostate Group of the Italian Association for Radiation Oncology (AIRO), Italy; 7 Radiation Oncology Department, University and Spedali Civili Hospital, Brescia, Italy; 8 Azienda Ospedaliera S. Maria, Terni, Italy; 9 Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; 10 Department of Radiation Oncology, Ospedale Policlinico San Martino and University of Genoa, Genoa, Italy; 11 Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; 12 Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy; 13 Medical Oncology Unit, Veneto Institute of Oncology IOVIRCCS, Padua, Italy; 14 Department of Urology, University Federico II, Naples, Italy; 15 Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy; 16 Department of Urology, Humanitas Gradenigo University, Turin, Italy; 17 National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy; 18 Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Padua, Italy; 19 Radiotherapy, Teaching Hospital S. Croce e Carle, Cuneo, Italy; 20 Urology Unit, Sant'Andrea Hospital, University of Rome La Sapienza, Rome, Italy; 21 Urology Unit, Azienda Socio-Sanitaria Territoriale Lariana, 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), radiotherapy 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, 1 537 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: Prostate cancer; Health-related quality of life; Patient-reported outcomes measure; Radical prostatectomy; Radiation therapy; Active surveillance

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