Abstract
Objective: To analyze the health-related quality of life (HRQoL) and survival of real-world prostate cancer (PC) patients and to calculate quality-adjusted life-years (QALYs) experienced under different treatment strategies. Materials and Methods: PC patients undergoing active surveillance (n = 226), radiation treatment (n = 280), surgery (n = 299), or hormonal treatment (n = 62) responded to the generic 15-dimensional (15D) HRQoL questionnaire at the time of the diagnosis and were followed up 3, 6, 12, and 24 months later. QALYs experienced during the follow-up were calculated for each treatment group, and variables associated with survival were analyzed using Cox proportional hazards models. Results: HRQoL was stable during the first 2 years after diagnosis in all other treatment groups, except in patients treated with hormonal therapy. The overall survival within 6.5-year follow-up time was 84.4%. The number of QALYs experienced during the 2-year follow-up was similar in patients in active surveillance (1.790), surgery (1.784), and radiation groups (1.767), but significantly lower in the hormonal therapy group (1.665). Conclusions: Patients receiving hormonal treatment had significantly impaired HRQoL and survival compared with other treatments. Although the number of QALYs experienced was similar in the 3 other treatment lines, there were marked differences between treatment lines on some 15D dimensions.
References
1.
Bray
F
, Ferlay
J
, Soerjomataram
I
, Siegel
RL
, Torre
LA
, Jemal
A
. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries
. CA Cancer J Clin
. 2018
;68
(6
):394
–424
. 2.
Culp
MB
, Soerjomataram
I
, Efstathiou
JA
, Bray
F
, Jemal
A
. Recent global patterns in prostate cancer incidence and mortality rates
. Eur Urol
. 2020 Jan
;77
(1
):38
–52
. Epub 2019 Sep 4
. 3.
Allemani
C
, Weir
HK
, Carreira
H
, Harewood
R
, Spika
D
, Wang
XS
, et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2)
. Lancet
. 2015
;385
(9972
):977
–1010
. 4.
Harewood
JL
, Hamdy
FC
, Lane
JA
, Mason
M
, Metcalfe
C
, Walsh
E
, et al. Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer
. N Engl J Med
. 2016 Oct 13
;375
(15
):1425
–37
. 5.
Cheung
AS
, de Rooy
C
, Hoermann
R
, Lim Joon
D
, Zajac
JD
, Grossmann
M
. Quality of life decrements in men with prostate cancer undergoing androgen deprivation therapy
. Clin Endocrinol
. 2017
;86
(3
):388
–94
. 6.
Dickey
SL
, Grayson
CJ
. The quality of life among men receiving active surveillance for prostate cancer: an integrative review
. Healthcare
. 2019 Jan 22
;7
(1
):14
.7.
Shevach
J
, Weiner
A
, Morgans
AK
. Quality of life-focused decision-making for prostate cancer
. Curr Urol Rep
. 2019 Aug 29
;20
(10
):57
. 8.
Albkri
A
, Girier
D
, Mestre
A
, Costa
P
, Droupy
S
, Chevrot
A
. Urinary incontinence, patient satisfaction, and decisional regret after prostate cancer treatment: a French national study
. Urol Int
. 2018
;100
(1
):50
–6
. 9.
Hurwitz
LM
, Cullen
J
, Elsamanoudi
S
, Kim
DJ
, Hudak
J
, Colston
M
, et al. A prospective cohort study of treatment decision-making for prostate cancer following participation in a multidisciplinary clinic
. Urol Oncol
. 2016
;34
(5
):233
, 25
. 10.
Sartor
O
. Endpoints in prostate cancer clinical trials
. Urology
. 2002 Sep
;60
(3 Suppl 1
):101
–8
; discussion 107–8
. 11.
Collette
L
, van Andel
G
, Bottomley
A
, Oosterhof
GO
, Albrecht
W
, de Reijke
TM
, et al. Is baseline quality of life useful for predicting survival with hormone-refractory prostate cancer? A pooled analysis of three studies of the European Organisation for Research and Treatment of Cancer Genitourinary Group
. J Clin Oncol
. 2004 1
;22
(19
):3877
–85
. 12.
Sullivan
PW
, Nelson
JB
, Mulani
PM
, Sleep
D
. Quality of life as a potential predictor for morbidity and mortality in patients with metastatic hormone-refractory prostate cancer
. Qual Life Res
. 2006 Oct
;15
(8
):1297
–306
. 13.
Halabi
S
, Vogelzang
NJ
, Kornblith
AB
, Ou
SS
, Kantoff
PW
, Dawson
NA
, et al. Pain predicts overall survival in men with metastatic castration-refractory prostate cancer
. J Clin Oncol
. 2008 20
;26
(15
):2544
–9
. 14.
Braun
DP
, Gupta
D
, Staren
ED
. Predicting survival in prostate cancer: the role of quality of life assessment
. Support Care Cancer
. 2012 Jun
;20
(6
):1267
–74
. 15.
Gupta
D
, Braun
DP
, Staren
ED
. Prognostic value of changes in quality of life scores in prostate cancer
. BMC Urol
. 2013 Jul 10
;13
:32
. 16.
Lis
CG
, Gupta
D
, Grutsch
JF
. Patient satisfaction with health-related quality of life: implications for prognosis in prostate cancer
. Clin Genitourin Cancer
. 2008
;6
(2
):91
–6
. 17.
van den Bergh
RC
, Roemeling
S
, Roobol
MJ
, Roobol
W
, Schröder
FH
, Bangma
CH
. Prospective validation of active surveillance in prostate cancer: the PRIAS study
. Eur Urol
. 2007 Dec
;52
(6
):1560
–3
. 18.
Sintonen
H
. The 15D instrument of health-related quality of life: properties and applications
. Ann Med
. 2001
;33
(5
):328
–36
. 19.
Lloyd
T
, Hounsome
L
, Mehay
A
, Mee
S
, Verne
J
, Cooper
A
. Lifetime risk of being diagnosed with, or dying from, prostate cancer by major ethnic group in England 2008–2010
. BMC Med
. 2015 Jul 30
;13
:171-015-0405-5
. 20.
Antonelli
A
, Palumbo
C
, Noale
M
, Porreca
A
, Maggi
S
, Simeone
C
, et al. Impact of surgical approach on patient-reported outcomes after radical prostatectomy: a propensity score-weighted analysis from a multicenter, prospective, observational study (The Pros-IT CNR Study)
. Urol Int
. 2019
;103
(1
):8
–18
. 21.
Merriel
SWD
, May
MT
, Martin
RM
. Predicting prostate cancer progression: protocol for a retrospective cohort study to identify prognostic factors for prostate cancer outcomes using routine primary care data
. BMJ Open
. 2018 Jan 31
;8
(1
):e019409
. © 2020 S. Karger AG, Basel
2020
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.
