Takizawa Itsuhiro, Hara Noboru, Nishiyama Tsutomu, Kaneko Masaaki, Hoshii Tatsuhiko, Tsuchida Emiko, Takahashi Kota
Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
Asian J Androl. 2009 May;11(3):283-90. doi: 10.1038/aja.2009.10. Epub 2009 Apr 6.
Health-related quality-of-life (HRQOL) after a radical prostatectomy (RP) or external beam radiation therapy (EBRT) has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP (n=86) and EBRT (n=76) for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP (79%) and 54 EBRT (79%) patients over a 3-year follow-up period (median: 41 months) using the Medical Outcomes Study Short Form-36 (SF-36) and the University of California Los Angeles Prostate Cancer Index (UCLA PCI). The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk (74.6% vs. 75.0%, P=0.931) and intermediate-risk (61.3% vs. 71.1%, P=0.691) patients. For high-risk patients, progression-free survival was lower in the RP group (45.1%) than in the EBRT group (79.7%) (P=0.002). The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group (P<0.001, P<0.05 and P<0.001, respectively). With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group (P<0.001 for each). The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients (P<0.001). Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient's HRQOL after treatment did not depend on biochemical recurrence.
根治性前列腺切除术（RP）或外照射放疗（EBRT）后的健康相关生活质量（HRQOL）尚未与疾病风险分层相关的肿瘤学结局结合起来进行研究。此外，这些治疗方法的长期结局也未得到研究。我们回顾性分析了连续接受RP（n = 86）和EBRT（n = 76）治疗局限性前列腺癌患者的肿瘤学结局。在3年的随访期（中位数：41个月）内，使用医学结局研究简表-36（SF-36）和加利福尼亚大学洛杉矶分校前列腺癌指数（UCLA PCI），可以对62例RP（79%）和54例EBRT（79%）患者的HRQOL和功能结局进行评估。对于低风险（74.6%对75.0%，P = 0.931）和中风险（61.3%对71.1%，P = 0.691）患者，RP组和EBRT组的5年无生化进展生存率无差异。对于高风险患者，RP组的无进展生存率（45.1%）低于EBRT组（79.7%）（P = 0.002）。两组的总体HRQOL相当。关于功能结局，RP组在尿功能方面的得分低于EBRT组，且尿路困扰和性困扰也少于EBRT组（分别为P < 0.001、P < 0.05和P < 0.001）。按风险分层，RP组的低风险和中风险患者的尿功能比EBRT组的患者差（每组P < 0.001）。EBRT组高风险患者的性功能优于相同风险的RP组患者（P < 0.001）。两组中生化复发均与UCLA PCI评分无关。总之，接受RP治疗的低至中风险患者在长期随访期间可能报告尿功能相对下降。治疗后患者的HRQOL并不取决于生化复发。
