Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.
Qual Life Res. 2011 Jun;20(5):713-21. doi: 10.1007/s11136-010-9805-3. Epub 2010 Dec 4.
Localized prostate cancer (LPC) patients are faced with numerous treatment options, including observation or watchful waiting. The choice of treatment largely depends on their baseline health-adjusted life expectancy (HALE). By consensus, physicians recommend treatment if the patient's HALE is ten or more years. However, the estimation of HALE is difficult. Although subjective by nature, self-rated health (SRH) is a robust predictor of mortality. We studied the usefulness of SRH in estimating HALE in patients who are considering treatment for LPC.
A total of 144 LPC patients from a large urology private practice in Norfolk, Virginia, were surveyed before they had chosen a treatment option.
HALE determined by SRH correlated well with objective health measures and was higher than age-based life expectancy by an average of 2 years. The observed difference in life expectancy due to SRH adjustment was higher among patients with a better socioeconomic and health profile.
SRH is an easy-to-use indicator of HALE in LPC patients. A table for HALE estimation by age and SRH is provided for men aged 70-80 years. Additional research with larger samples and prospective study designs are needed before the SRH method can be used in primary care and urology settings.
局限性前列腺癌(LPC)患者面临着众多的治疗选择,包括观察或等待观察。治疗方案的选择主要取决于他们的基线健康调整预期寿命(HALE)。根据共识,如果患者的 HALE 为十年或更长时间,医生建议进行治疗。然而,HALE 的估计是困难的。虽然自评健康(SRH)本质上是主观的,但它是死亡率的有力预测指标。我们研究了在考虑治疗 LPC 的患者中,SRH 估计 HALE 的有用性。
弗吉尼亚州诺福克的一家大型泌尿科私人诊所的 144 名 LPC 患者在选择治疗方案之前接受了调查。
SRH 确定的 HALE 与客观健康指标相关性良好,平均比基于年龄的预期寿命高 2 年。在具有更好的社会经济和健康状况的患者中,由于 SRH 调整而导致的预期寿命差异更高。
SRH 是 LPC 患者 HALE 的一种易于使用的指标。提供了一个根据年龄和 SRH 估计 HALE 的表,适用于 70-80 岁的男性。需要进行更多的具有更大样本量和前瞻性设计的研究,才能在初级保健和泌尿科环境中使用 SRH 方法。