Dynamic Changes of Generic Quality of Life after Different Treatments for Localized Prostate Cancer

Abstract

Generic quality of life (QoL) is an important issue in decision making related to the primary treatment of localized prostate cancer (PC). This study assessed the dynamic changes of QoL in patients with localized PC under different treatment modalities. From 2013 to 2018, we prospectively assessed QoL scores in patients with localized PC under unitary treatment using the World Health Organization Quality of Life (WHOQOL) BREF version. The trajectories of the QoL scores after different treatments were estimated using a kernel-smoothing method. Dynamic changes in the major determinants were analyzed using a mixed effects model. The clinical features of the participants in our institute were compared with PC patients in Taiwan’s cancer registry. A total of 196 patients were enrolled with 491 repeated assessments. The participants shared similar clinical characteristics with the PC patients in Taiwan as a whole. Patients with lower household incomes showed statistically significant lower scores on all four domains and related facets, while PC survivors with comorbidities of anxiety and/or diabetes appeared to be affected on the physical domain and related facets. After controlling for these determinants, patients under active surveillance or observation demonstrated significantly higher QoL scores in the physical and social domains, as well as several facets belonging to these domains, in mixed models compared with patients undergoing radical prostatectomy or radiotherapy within the first year. The generic QoL scores were higher within the first year in patients receiving active surveillance or observation after controlling other significant factors. The difference diminished after one year of post management. More studies are needed to corroborate our findings.

Dynamic Changes in Quality of Life, Psychological Status, and Body Image in Women With Different Types of Breast Cancer Surgery: 8-year Follow Up

“…A kernel-type smoother was applied to demonstrate the dynamic changes in the item scores, domain scores, and total scores for the Taiwan version of the WHOQOL-BREF, the EQ5D anxiety/depression items, and the total BIS score [33,65,68] using STATA version 17.0 software. Groups comprising various pairings of mastectomy, MRM, and BR were used to compare the trends in QoL, anxiety/depression, and BI changes over time.…”

“…For this study, age, marital status, education levels, family income, co-morbidities, pathological stage, type of lymph node dissection, sentinel lymph node biopsy, time since chemotherapy, radiotherapy, hormone therapy, and interactions among types of surgeries (mastectomy, MRM, and BR) were considered as a possible confounding factors according to previous literature [33,65,67]. Age was continuously calculated at each QoL assessment.…”

“…This study is a comprehensive analysis intended to show the long-term health effects of mastectomy and MRM compared with BR across the lifetime using real-life data because few studies have been conducted examining the dynamic changes in QoL, psychological status, and BI in women who have undergone BR compared with different types of mastectomies alone. Such studies have generally had examined short-term follow-up in Asian populations as well as globally [25,33,65,67]. The results of this study will help healthcare teams update and determine when and how to improve QoL among women with different types of mastectomies and BR since the choice of surgical treatment heavily in uences these patients' long-term QoL, psychological status, and BI [8,41,51,65].…”

Determinants and Dynamic Changes of Generic Quality of Life in Human Bladder Cancer Patients

“…Thus, the score of each domain ranges from 4 to 20. With two additional locally specific items (being respected and eating), the Taiwanese version of the WHOQOL-BREF has been validated to exhibit a good test–retest reliability (correlation coefficient > 0.75), good internal consistency reliability (Cronbach’s α > 0.91), and good construct validity in patients with several malignancies [ 23 , 24 , 25 ].…”

Health-related quality of life in prostate cancer patients in the Silesian Province (Poland) before and after radical prostatectomy – a longitudinal observational pilot study

“…As early as the point of diagnosis, reduction in the quality of life may be observed on the emotional, cognitive and social levels, among others [10]. This reduction not only results from the fact that patients are confronted with the disease itself, but is also associated with patients' beliefs, and the beliefs of those in their immediate environment, resulting from their understanding of prostate cancer and its treatment [9,10,11]. Quality of life has therefore become not only an integral part of the comprehensive assessment of cancer treatment outcomes, but also an important component in the treatment selection itself.…”