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肥胖对耻骨后根治性前列腺切除术后与健康相关的生活质量结局并无不利影响。

Obesity does not adversely affect health-related quality-of-life outcomes after anatomic retropubic radical prostatectomy.

作者信息

Freedland Stephen J, Haffner Michael C, Landis Patricia K, Saigal Christopher S, Carter H Ballentine

机构信息

James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2101, USA.

出版信息

Urology. 2005 Jun;65(6):1131-6. doi: 10.1016/j.urology.2004.12.064.

Abstract

OBJECTIVES

To study the impact of obesity on the health-related quality-of-life (HRQOL) outcomes after radical prostatectomy (RP).

METHODS

Patient-reported sexual and urinary HRQOL was assessed at baseline and 3, 6, 12, and 24 months after anatomic retropubic RP using the University of California, Los Angeles, Prostate Cancer Index among a cohort of 340 men. Linear regression analysis was used to compare the longitudinal HRQOL scores by body mass index (BMI) adjusting for age, baseline HRQOL, and nerve-sparing status (non-nerve sparing versus unilateral versus bilateral).

RESULTS

At baseline, the sexual and urinary function and bother scores were similar between normal-weight (BMI less than 25 kg/m2), overweight (BMI 25.0 to 29.9 kg/m2), and obese (BMI 30 kg/m2 or greater) men. Obese men were as likely to undergo bilateral nerve-sparing surgery as men with a lower BMI. After adjustment for age, baseline HRQOL, and nerve-sparing status, no statistically significant differences were found in any HRQOL score at any point among the BMI groups, except for a lower urinary function score at 24 months among overweight men (P = 0.02).

CONCLUSIONS

In a select group of men undergoing RP at a tertiary care referral center, BMI was, in general, unrelated to the baseline and longitudinal postoperative HRQOL scores. Obese men (BMI 30 to 35 kg/m2) should not be selectively discouraged against RP because of concerns about HRQOL. Additional studies are needed to assess the HRQOL outcomes among men with very high BMI values (greater than 35 kg/m2).

摘要

目的

研究肥胖对根治性前列腺切除术后健康相关生活质量(HRQOL)结果的影响。

方法

在340名男性队列中,采用加利福尼亚大学洛杉矶分校前列腺癌指数,于解剖性耻骨后前列腺切除术前及术后3、6、12和24个月评估患者报告的性与泌尿HRQOL。使用线性回归分析,通过调整年龄、基线HRQOL和神经保留状态(非神经保留、单侧神经保留与双侧神经保留),比较不同体重指数(BMI)组的纵向HRQOL得分。

结果

在基线时,体重正常(BMI小于25kg/m²)、超重(BMI 25.0至29.9kg/m²)和肥胖(BMI 30kg/m²或更高)男性的性功能、泌尿功能及困扰得分相似。肥胖男性接受双侧神经保留手术的可能性与BMI较低的男性相同。在调整年龄、基线HRQOL和神经保留状态后,BMI组间在任何时间点的任何HRQOL得分均未发现统计学上的显著差异,但超重男性在术后24个月的泌尿功能得分较低(P = 0.02)。

结论

在一家三级医疗转诊中心接受前列腺切除术的特定男性群体中,总体而言,BMI与基线及术后纵向HRQOL得分无关。不应因担心HRQOL而选择性地劝阻肥胖男性(BMI 30至35kg/m²)接受前列腺切除术。需要进一步研究以评估BMI值非常高(大于35kg/m²)的男性的HRQOL结果。

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