Health-related quality of life among long-term (≥5 years) prostate cancer survivors by primary intervention: a systematic review

Abstract

BackgroundDue to an improving prognosis, and increased knowledge of intervention effects over time, long-term well-being among prostate cancer (PC) survivors has gained increasing attention. Yet, despite a variety of available PC interventions, experts currently disagree on optimal intervention course based on survival rates.MethodsIn January 2017, we searched multiple databases to identify relevant articles. Studies were required to assess at least two different dimensions of health-related quality of life (HRQoL) in PC survivors ≥5 years past diagnosis with validated measures.ResultsIdentified studies (n = 13) were mainly observational cohort studies (n = 10), conducted in developed countries with a sample size below 100 per study arm (n = 6). External-beam radiation therapy was the most common intervention (n = 12), whereas only three studies included patients on active surveillance or on watchful waiting.Studies were largely heterogeneous in cancer stage at diagnosis, intervention groups and instruments. All identified studies either used the EORTC QLQ-C30 (n = 5) or the SF-36 (n = 7) to assess generic HRQoL, yet 11 different instruments were employed to assess PC specific urinary, bowel and sexual symptoms. Overall, no consistent pattern between intervention and HRQoL was observed. Results from two randomized-controlled-trials (RCTs) and one observational study, comparing HRQoL by primary intervention in localized PC survivors suggest that long-term HRQoL does not differ by intervention. However, observational studies that included a combination of localized and locally advanced stage PC survivors identified HRQoL differences for various scales including physical well-being, social and role function, vitality, and role emotional.ConclusionThis review reveals the number of publications comparing HRQoL by primary intervention in long-term PC survivors is currently limited. Robust data from two RCTs and one observational study suggest that HRQoL does not seem to differ by intervention. However, the heterogeneity of studies’ methodologies and results hindered our ability to draw a clear conclusion. Therefore, in order to answer the question of which primary intervention is superior with respect to long-term HRQoL in PC patients, more high-quality, large-scale prospective cohort studies, or RCTs with repeated HRQoL assessments, are urgently needed.Electronic supplementary materialThe online version of this article (10.1186/s12955-017-0836-0) contains supplementary material, which is available to authorized users.

Health‐related quality of life in long‐term survivors with localised prostate cancer by therapy—Results from a population‐based study

“…Until now, only limited information was available for this specific group (Adam et al, 2018). Our population-based design, including patient recruitment via multiple population-based cancer registries, results in a socio-demographically diverse cohort with patients included who were not exclusively treated at large academic centres.…”

“…Additionally, our study adds valuable information on the effect of ADT on HRQoL for longterm survivors diagnosed with localised PC. Until now, only limited information was available for this specific group (Adam et al, 2018).…”

“…In general, patients with localised PC experience very good five-year relative rates of 90% to 95% in developed countries (National Cancer Institute, 2018;Robert Koch Institut, 2017) and are more likely to die of causes other than the disease (Stattin et al, 2010). Given the lack of agreement on optimal PC treatment and the limited knowledge regarding long-term effects in survivors with localised PC, it is increasingly important to assess PC survivors' long-term HRQoL (≥5 years after diagnosis) (American Cancer Society, 2000) by treatment (Drummond et al, 2015;Adam, Feller, Rohrmann, & Arndt, 2018).…”

“…A recent review suggests that HRQoL scores do not seem to differ by primary therapy in long-term survivors diagnosed with localised PC (Adam et al, 2018). However, the included studies, which investigated HRQoL by treatment in localised PC, used different comparison groups and included a total of four different treatments.…”

Health-related Quality of Life in long-term Prostate Cancer Survivors after Nerve-Sparing and Non-Nerve-Sparing Radical Prostatectomy – Results from the multiregional PROCAS study

“…Although radical prostatectomy (RP) is the most common treatment strategy for men diagnosed with prostate cancer (PC) [1], the survival benefit for PC survivors treated with RP compared to other primary management options remains unclear [2][3][4]. In addition, RP may have strong both acute and long-lasting detrimental effects, notably on urinary and sexual functioning [5][6][7].…”