| Quality-of-life impact of primary treatments for localized prostate cancer in patients without hormonal treatment. | |
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MedLine Citation:
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PMID: 20921463 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Earlier studies evaluating the effect on quality of life (QoL) of localized prostate cancer interventions included patients receiving adjuvant hormone therapy, which could have affected their outcomes. Our objective was to compare the QoL impact of the three most common primary treatments on patients who were not receiving adjuvant hormonal treatment. PATIENTS AND METHODS: This was a prospective study of 435 patients treated with radical prostatectomy, external-beam radiotherapy, or brachytherapy. QoL was assessed before and after treatment with the Short Form-36 and the Expanded Prostate Cancer Index Composite. Differences between groups were tested by analysis of variance. Distribution of outcome at 3 years was examined by stratifying according to baseline status. Generalized estimating equation models were constructed to assess the effect of treatment over time. RESULTS: Compared with the brachytherapy group, the prostatectomy group showed greater deterioration on urinary incontinence and sexual scores but better urinary irritative-obstructive results (-18.22, -13.19, and +6.38, respectively, at 3 years; P < .001). In patients with urinary irritative-obstructive symptoms at baseline, improvement was observed in 64% of those treated with nerve-sparing radical prostatectomy. Higher bowel worsening (-2.87, P = .04) was observed in the external radiotherapy group, with 20% of patients reporting bowel symptoms. CONCLUSION: Radical prostatectomy caused urinary incontinence and sexual dysfunction but improved pre-existing urinary irritative-obstructive symptoms. External radiotherapy and brachytherapy caused urinary irritative-obstructive adverse effects and some sexual dysfunction. External radiotherapy also caused bowel adverse effects. Relevant differences between treatment groups persisted for up to 3 years of follow-up, although the difference in sexual adverse effects between brachytherapy and prostatectomy tended to decline over long-term follow-up. These results provide valuable information for clinical decision making. |
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Authors:
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Yolanda Pardo; Ferran Guedea; Ferrán Aguiló; Pablo Fernández; Víctor Macías; Alfonso Mariño; Asunción Hervás; Ismael Herruzo; María José Ortiz; Javier Ponce de León; Jordi Craven-Bratle; José Francisco Suárez; Ana Boladeras; Àngels Pont; Adriana Ayala; Gemma Sancho; Evelyn Martínez; Jordi Alonso; Montserrat Ferrer |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-04 |
Journal Detail:
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Title: Journal of clinical oncology : official journal of the American Society of Clinical Oncology Volume: 28 ISSN: 1527-7755 ISO Abbreviation: J. Clin. Oncol. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-29 Completed Date: 2010-11-09 Revised Date: 2011-03-23 |
Medline Journal Info:
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Nlm Unique ID: 8309333 Medline TA: J Clin Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 4687-96 Citation Subset: IM |
Affiliation:
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Institut Municipal d'Investigacions Mèdiques-Hospital del Mar, Barcelona, Bellaterra, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brachytherapy / adverse effects* Constriction, Pathologic / epidemiology, etiology Erectile Dysfunction / epidemiology*, etiology Fecal Incontinence / epidemiology*, etiology Health Status Humans Incidence Male Middle Aged Prospective Studies Prostatectomy / adverse effects*, methods Prostatic Neoplasms / pathology, physiopathology, radiotherapy*, surgery* Quality of Life* Questionnaires Radiotherapy / adverse effects, methods Research Design Survival Analysis Time Factors Treatment Outcome Urinary Incontinence / epidemiology*, etiology Urination* |
| Comments/Corrections | |
Comment In:
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J Clin Oncol. 2010 Nov 1;28(31):4667-8
[PMID:
20921452
]
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Erratum In:
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J Clin Oncol. 2011 Feb 20;29(6):779 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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