Prospective longitudinal outcomes of quality of life after laparoscopic radical prostatectomy compared with retropubic radical prostatectomy

Abstract

BackgroundThere have been few reports on health-related quality of life (HRQOL) after laparoscopic radical prostatectomy (LRP) in Japanese patients. The aim of this study is to assess changes in HRQOL during 36 months after LRP compared with retropubic radical prostatectomy (RRP).MethodsThe subjects were 105 consecutive patients treated with LRP between 2011 and 2012. HRQOL was evaluated using the International Prostate Symptom Score (IPSS), Medical Outcome Study 8-Items Short Form Health Survey (SF-8), and Expanded Prostate Cancer Index Composite (EPIC) at baseline and 1, 3, 6, 12 and 36 months after surgery. These results were compared with data for 107 consecutive patients treated with RRP between 2005 and 2007. The comparison between LRP and RRP was examined at every time point by Mann-Whitney U-test and chi-square test. Multiple linear regression analysis was used to identify independent factors related to the urinary domain in EPIC.ResultsThe IPSS change was similar in both groups. The LRP group had a better SF-8 mental component summary score at baseline and a better SF-8 physical component summary score at 1 month after surgery. In EPIC, urinary function and bother were worse after LRP, but improved at 12 months and did not differ significantly from those after RRP; however, these factors then worsened again at 36 months after LRP. Urinary incontinence was also worse at 36 months after LRP, compared to RRP. In patients treated with nerve-sparing surgery, urinary function and urinary incontinence were similar and good at 12 and 36 months in both groups. Bowel function and bother, and sexual function and bother were similar in both groups and showed no changes from 12 to 36 months. Age and salvage radiotherapy were independent predictors of incontinence (daily use of two or more pads) in multivariate analysis. Surgical procedure was not an independent factor for incontinence, but incontinence defined as use of one pad or more was associated with the surgical procedure.ConclusionsUrinary function and bother at 36 months were worse after LRP than after RRP. Age, salvage radiotherapy and surgical procedure were associated with urinary incontinence after 36 months.

Longitudinal changes in factors affecting postoperative patient satisfaction after robot-assisted radical prostatectomy: an assessment using a patient-reported questionnaire

“…These results are consistent with the results reported in previous studies. 5,11 In the present study, both BF and BB scores signi cantly worsened at 1 month postoperatively compared with those at baseline (p < 0.001 for both) and then gradually improved. The EPIC bowel domain is mainly meant to evaluate the impact of radiotherapy on QOL.…”

Changes in sexual function and serum testosterone levels in patients with prostate cancer after image-guided proton therapy

“…A large number of studies have reported a decline in sexual function due to surgery, and improvements are difficult even with robot-assisted radical prostatectomy [ 40–42 ]. The sexual summary domain score decreased by ~3- to 4-fold of the MID (i. e. 30–40 points) after surgery; therefore, sexual function preservation after IGPT was considered to be good.…”

Patient-reported outcomes after robot-assisted radical prostatectomy and institutional learning curve for functional outcomes

“…The surgical indications and procedures were the same as those for LRP, as described previously. [ 6 ] An antegrade surgical technique was used with an intraperitoneal or retroperitoneal approach, with the choice of approach dependent on the patient’s condition. [ 9 ] All patients underwent posterior and anterior wall reconstruction.…”

“…found that physician ratings of symptoms do not correlate well with PROs, and that disagreement between physician and patient ratings did not decrease over time. [ 5 ] We have reported PROs for ORP compared to LRP,[ 6 , 7 ] with the finding that ORP was better for urinary incontinence. However, we have not examined the outcomes of RARP, and there are few reports on this surgery using PROs in Japan.…”