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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

Salome Adam, Eva Martin-Diener, Bertrand Camey, Céline Egger Hayoz, Isabelle Konzelmann, Seyed Mohsen Mousavi, Christian Herrmann, Sabine Rohrmann, Miriam Wanner, Katharina Staehelin, Räto T Strebel, Marco Randazzo, Hubert John, Hans-Peter Schmid & Volker Arndt

abstract

BACKGROUND
Nerve-sparing (NS) surgery was developed to improve postoperative sexual and potentially urological outcomes after radical prostatectomy (RP). However, it is largely unknown how NSRP affects health-related quality of life (HRQoL) including urinary and sexual outcomes in prostate cancer (PC) survivors 5-10 years after diagnosis in comparison with Non-NSRP.

METHODS
The study population included 382 stage pT2-T3N0M0 PC survivors 5-10 years post diagnosis, who were identified from the multiregional Prostate Cancer Survivorship in Switzerland (PROCAS) study. Briefly, in 2017/2018, PC survivors were identified via six population-based cancer registries based in both German- and French-speaking Switzerland. HRQoL and PC-specific symptom burden was assessed using the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires. Differences in HRQoL outcomes between survivors treated with NSRP (uni- & bilateral) and Non-NSRP were analyzed with multivariable linear regression adjusted for age, years since diagnosis, cancer stage, comorbidities at diagnosis, and further therapies, if appropriate. Multiple imputation was performed to minimize the bias due to missing data.

RESULTS
Five to ten years after diagnosis, PC survivors treated with NSRP and Non-NSRP reported similar symptom burden and comparable HRQoL function scores. The only significant differences were reported for sexual activity, whereas PC survivors who underwent NSRP reported statistically significant (P = .031) higher sexual activity than those on Non-NSRP. NSRP and Non-NSRP reported similar scores for urinary symptoms and all other HRQoL outcomes.

CONCLUSIONS
Our results support nerve-sparing techniques as an option to improve postoperative sexual, but not urinary outcomes after RP in long-term PC survivors.
   
citation Adam S, Martin-Diener E, Camey B, Egger Hayoz C, Konzelmann I, Mohsen Mousavi S, Herrmann C, Rohrmann S, Wanner M, Staehelin K, Strebel R T, Randazzo M, John H, Schmid H P, Arndt V. 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. Cancer Med 2020; 9:5416-5424.
   
type journal paper/review (English)
date of publishing 10-06-2020
journal title Cancer Med (9/15)
ISSN electronic 2045-7634
pages 5416-5424
PubMed 32524704
DOI 10.1002/cam4.3197