Quality of life after radical prostatectomy, radiation therapy similar 15 years post-diagnosis

Atlanta-Long-term quality of life converges to similarity for prostate cancer patients treated surgically or by radiation therapy, data from a large cohort study show.

Differences in the frequency of urinary and sexual problems at 5 years tended to disappear by 15 years. Moreover, the extent to which patients found the problems bothersome did not differ.

The results could prove useful for discussions with patients about treatment options for localized prostate cancer, first author Matthew Resnick, MD, reported at the AUA annual meeting in Atlanta.

Reports of similar long-term disease control with surgery or radiation therapy have focused attention on potential differences in adverse effects and quality of life (QoL). Though short-term QoL has been studied extensively, a relative paucity of data exists about the long-term effects of different treatment modalities.

To examine long-term health-related QoL after definitive treatment of localized prostate cancer, Dr. Resnick and colleagues evaluated outcomes from the Prostate Cancer Outcomes Study (PCOS), an observational prostate cancer cohort study that enrolled 3,718 men diagnosed with prostate cancer in 1994 and 1995.

The current analysis included 1,655 men with localized disease, ages 55 to 74 years, treated within 1 year of diagnosis by radical prostatectomy (n=1,164) or external beam radiation therapy (n=491). Urinary, sexual, and bowel function were assessed by means of the UCLA Prostate Cancer Index at baseline, 6 months, and 1, 2, 5, and 15 years after initial diagnosis.

At 15 years, 8.5% of the men who underwent radical prostatectomy reported no control over urine leakage or frequent leakage, as compared with 2.6% of the radiation therapy group. Although the figures translated into an odds ratio of 2.34 (95% CI, 0.88-6.23) for urinary dysfunction in the prostatectomy group, the difference failed to achieve statistical significance.