Kakehi Yoshiyuki, Takegami Misa, Suzukamo Yoshimi, Namiki Shunichi, Arai Yoichi, Kamoto Toshiyuki, Ogawa Osamu, Fukuhara Shunichi
Department of Urology, Kagawa University Faculty of Medicine, Kagawa, Japan.
J Urol. 2007 May;177(5):1856-61. doi: 10.1016/j.juro.2007.01.066.
Health related quality of life in Japanese men with localized prostate cancer treated with current multidisciplinary treatment modalities was assessed using a newly developed Japanese version of the Extended Prostate Cancer Index Composite. We evaluated psychometric properties of the Japanese version of the Extended Prostate Cancer Index Composite.
A cross-sectional analysis of health related quality of life was done in 460 patients treated with radical prostatectomy, external beam radiation therapy, permanent (125)I seed implantation androgen deprivation therapy or watchful waiting. Patients were enrolled in January to July 2005. Serum testosterone was measured in all participants.
Missing values ranged from 0.4% to 16.3% with 10% or greater observed for 15 of 50 items (30%). A missing value of 10% or greater correlated with higher age and lower educational background (p<0.05). Internal consistency reliability was 0.7 or higher for almost all subscales except the bowel function and hormonal function subscales. Test-retest reliability and factor validity were successfully verified. Known groups validity revealed significant improvement in urinary domain scores with time in patients treated with radical prostatectomy plus permanent (125)I seed implantation. Bowel domain scores were worse in patients treated with external beam radiation therapy compared to the other modalities. Decreased hormonal domain scores correlated with low serum testosterone (p<0.001). Salvage androgen deprivation therapy after radical prostatectomy negatively influenced sexual function but not sexual bother.
Reliability and validity of the Japanese version of the Extended Prostate Cancer Index Composite were verified, although revision is needed for it to be more comprehensible for elderly patients and those with low education. It can be used for cross-cultural assessment of health related quality of life in patients with localized prostate cancer treated with current multidisciplinary treatment modalities.
使用新开发的日语版扩展前列腺癌指数综合量表(Extended Prostate Cancer Index Composite,EPIC)评估采用当前多学科治疗模式治疗的日本局限性前列腺癌男性患者的健康相关生活质量。我们评估了日语版EPIC的心理测量特性。
对460例接受根治性前列腺切除术、外照射放疗、永久性(125)I粒子植入雄激素剥夺治疗或观察等待的患者进行了健康相关生活质量的横断面分析。患者于2005年1月至7月入组。对所有参与者测量血清睾酮。
缺失值范围为0.4%至16.3%,50项中有15项(30%)观察到缺失值为10%或更高。缺失值为10%或更高与年龄较大和教育背景较低相关(p<0.05)。除肠道功能和激素功能子量表外,几乎所有子量表的内部一致性信度均为0.7或更高。重测信度和因子效度得到成功验证。已知组效度显示,接受根治性前列腺切除术加永久性(125)I粒子植入治疗的患者,其尿域评分随时间显著改善。与其他治疗方式相比,接受外照射放疗的患者肠道域评分更差。激素域评分降低与血清睾酮水平低相关(p<0.001)。根治性前列腺切除术后挽救性雄激素剥夺治疗对性功能有负面影响,但对性困扰无影响。
日语版EPIC的信度和效度得到了验证,不过为了使其对老年患者和低教育程度患者更易懂,仍需修订。它可用于对采用当前多学科治疗模式治疗的局限性前列腺癌患者的健康相关生活质量进行跨文化评估。