Patient-reported functional outcome measures and treatment choice for prostate cancer.

Male Humans Prospective Studies Australia Prostatectomy Prostatic Neoplasms / radiotherapy Brachytherapy Patient Reported Outcome Measures Treatment Outcome Quality of Life
Australia Patient reported outcome measure Prostate cancer Quality of life

Journal

BMC urology
ISSN: 1471-2490
Titre abrégé: BMC Urol
Pays: England
ID NLM: 100968571

Informations de publication

Date de publication:
05 Nov 2022
Historique:
received: 16 06 2022
accepted: 06 10 2022
entrez: 6 11 2022
pubmed: 6 11 2022
medline: 9 11 2022
Statut: epublish

Résumé

The aim of this study was to describe changes in patient-reported functional outcome measures (PROMs) comparing pre-treatment and 12 months after radical prostatectomy (RP), external beam radiation therapy (EBRT), brachytherapy and active surveillance (AS). Men enrolled from 2010 to 2019 in the South Australian Prostate Cancer Clinical Outcomes Collaborative registry a prospective clinical registry were studied. Urinary, bowel, and sexual functions were measured using Expanded Prostate Cancer Index Composite (EPIC-26) at baseline and 12 months post-treatment. Higher scores on the EPIC-26 indicate better function. Multivariable regression models were applied to compare differences in function and extent of bother by treatment. Of the 4926 eligible men, 57.0% underwent RP, 20.5% EBRT, 7.0% brachytherapy and 15.5% AS. While baseline urinary and bowel function varied little across treatment groups, sexual function differed greatly (adjusted mean scores: RP = 56.3, EBRT = 45.8, brachytherapy = 61.4, AS = 52.8; p < 0.001). Post-treatment urinary continence and sexual function declined in all treatment groups, with the greatest decline for sexual function after RP (adjusted mean score change - 28.9). After adjustment for baseline differences, post-treatment sexual function scores after EBRT (6.4; 95%CI, 0.9-12.0) and brachytherapy (17.4; 95%CI, 9.4-25.5) were higher than after RP. Likewise, urinary continence after EBRT (13.6; 95%CI, 9.0-18.2), brachytherapy (10.6; 95%CI, 3.9-17.3) and AS (10.6; 95%CI, 5.9-15.3) were higher than after RP. Conversely, EBRT was associated with lower bowel function (- 7.9; 95%CI, - 12.4 to - 3.5) than RP. EBRT and AS were associated with lower odds of sexual bother (OR 0.51; 95%CI, 0.29-0.89 and OR 0.60; 95%CI, 0.38-0.96, respectively), and EBRT with higher odds of bowel bother (OR 2.01; 95%CI, 1.23-3.29) compared with RP. The four common treatment approaches for prostate cancer were associated with different patterns of patient-reported functional outcomes, both pre- and 12 months post-treatment. However, after adjustment, RP was associated with a greater decline in urinary continence and sexual function than other treatments. This study underscores the importance of collecting baseline PROMs to interpret post-treatment functional outcomes.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this study was to describe changes in patient-reported functional outcome measures (PROMs) comparing pre-treatment and 12 months after radical prostatectomy (RP), external beam radiation therapy (EBRT), brachytherapy and active surveillance (AS).
METHODS METHODS
Men enrolled from 2010 to 2019 in the South Australian Prostate Cancer Clinical Outcomes Collaborative registry a prospective clinical registry were studied. Urinary, bowel, and sexual functions were measured using Expanded Prostate Cancer Index Composite (EPIC-26) at baseline and 12 months post-treatment. Higher scores on the EPIC-26 indicate better function. Multivariable regression models were applied to compare differences in function and extent of bother by treatment.
RESULTS RESULTS
Of the 4926 eligible men, 57.0% underwent RP, 20.5% EBRT, 7.0% brachytherapy and 15.5% AS. While baseline urinary and bowel function varied little across treatment groups, sexual function differed greatly (adjusted mean scores: RP = 56.3, EBRT = 45.8, brachytherapy = 61.4, AS = 52.8; p < 0.001). Post-treatment urinary continence and sexual function declined in all treatment groups, with the greatest decline for sexual function after RP (adjusted mean score change - 28.9). After adjustment for baseline differences, post-treatment sexual function scores after EBRT (6.4; 95%CI, 0.9-12.0) and brachytherapy (17.4; 95%CI, 9.4-25.5) were higher than after RP. Likewise, urinary continence after EBRT (13.6; 95%CI, 9.0-18.2), brachytherapy (10.6; 95%CI, 3.9-17.3) and AS (10.6; 95%CI, 5.9-15.3) were higher than after RP. Conversely, EBRT was associated with lower bowel function (- 7.9; 95%CI, - 12.4 to - 3.5) than RP. EBRT and AS were associated with lower odds of sexual bother (OR 0.51; 95%CI, 0.29-0.89 and OR 0.60; 95%CI, 0.38-0.96, respectively), and EBRT with higher odds of bowel bother (OR 2.01; 95%CI, 1.23-3.29) compared with RP.
CONCLUSION CONCLUSIONS
The four common treatment approaches for prostate cancer were associated with different patterns of patient-reported functional outcomes, both pre- and 12 months post-treatment. However, after adjustment, RP was associated with a greater decline in urinary continence and sexual function than other treatments. This study underscores the importance of collecting baseline PROMs to interpret post-treatment functional outcomes.

Identifiants

DOI: 10.1186/s12894-022-01117-1 PMID: 36335325 PMC: PMC9637295
pubmed: 36335325
doi: 10.1186/s12894-022-01117-1
pii: 10.1186/s12894-022-01117-1
pmc: PMC9637295
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

169

Subventions

Organisme : The Hospital Research Foundation
ID : C-PJ-09-Prost-2020

Informations de copyright

© 2022. The Author(s).

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Auteurs

Tenaw Tiruye (T)

Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia. Tenaw.Tiruye@unisa.edu.au.
Public Health Department,, Debre Markos University,, Debre Markos, Ethiopia. Tenaw.Tiruye@unisa.edu.au.

Michael O'Callaghan (M)

South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, South Australia.
Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia.
Discipline of Medicine, University of Adelaide, Adelaide, South Australia.
Urology Unit, Southern Adelaide Local Health Network, Adelaide, South Australia.

Kim Moretti (K)

Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia.
South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, South Australia.
Discipline of Surgery, University of Adelaide, Adelaide, South Australia.

Alex Jay (A)

Flinders Medical Centre, Bedford Park, South Australia.

Braden Higgs (B)

Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia.
Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia.

Kerry Santoro (K)

Urology Unit, Southern Adelaide Local Health Network, Adelaide, South Australia.

Terry Boyle (T)

Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia.

Kerry Ettridge (K)

Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia.
School of Public Health, University of Adelaide, Adelaide, South Australia.

Kerri Beckmann (K)

Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia.

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questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Procédures de chirurgie urologique masculine › Prostatectomie › Patient-reported functional outcome measures...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › Patient-reported functional outcome measures...
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questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Patient-reported functional outcome measures...
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