Arredondo Shelley A, Downs Tracy M, Lubeck Deborah P, Pasta David J, Silva Stefanie J, Wallace Katrine L, Carroll Peter R
Department of Urology, Urology Outcomes Research Group, University of California, San Francisco Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA.
J Urol. 2004 Nov;172(5 Pt 1):1830-4. doi: 10.1097/01.ju.0000140758.04424.77.
Watchful waiting is an alternative to active treatment for men with low risk prostate cancer but it is unclear how health related quality of life (HRQoL) may change over time for men who select this option. We report on HRQoL in men with localized prostate cancer who selected watchful waiting.
HRQoL outcomes were reviewed for 310 men diagnosed with prostate cancer from 1990 to 2001 within Cancer of the Prostate Strategic Urological Research Endeavor who chose watchful waiting. The UCLA Prostate Cancer Index and RAND 36-Item Health Survey were completed at enrollment and approximately every 6 months. A random slopes model was developed to assess time trends in HRQoL for up to 5 years after diagnosis, adjusting for age at diagnosis and specific comorbidities.
Significant decreases with time were observed in 7 domains of the RAND 36-Item Health Survey and 4 of the UCLA Prostate Cancer Index scales.
Men with prostate cancer who chose watchful waiting in the current study had better or similar HRQoL outcomes compared to men without prostate cancer at the start of the study. Many of these scores were significantly affected by increasing age and decreased with time. The physical domain scores as well as sexual function scores decreased more than expected from the aging process alone.
对于低风险前列腺癌男性患者，观察等待是积极治疗的一种替代方案，但尚不清楚选择该方案的男性患者与健康相关的生活质量（HRQoL）会随时间如何变化。我们报告了选择观察等待的局限性前列腺癌男性患者的HRQoL情况。
对1990年至2001年在前列腺癌战略泌尿学研究计划中被诊断为前列腺癌且选择观察等待的310名男性患者的HRQoL结果进行了回顾。加州大学洛杉矶分校前列腺癌指数和兰德36项健康调查在入组时及之后大约每6个月完成一次。建立了随机斜率模型，以评估诊断后长达5年的HRQoL时间趋势，并对诊断时的年龄和特定合并症进行了调整。
在兰德36项健康调查的7个领域以及加州大学洛杉矶分校前列腺癌指数量表的4个领域中，观察到随时间有显著下降。
在本研究中选择观察等待的前列腺癌男性患者，在研究开始时与无前列腺癌的男性相比，具有更好或相似的HRQoL结果。其中许多评分受年龄增长影响显著，并随时间下降。身体领域评分以及性功能评分的下降幅度超过了仅由衰老过程所预期的程度。
