Department of Urology of Klinikum Niederberg Velbert, University of Duisburg-Essen, Germany.
Health Qual Life Outcomes. 2011 Nov 2;9:93. doi: 10.1186/1477-7525-9-93.
Patients with newly diagnosed early stage prostate cancer (PCa) face a difficult choice of different treatment options with curative intention. They must consider both goals of optimising quantity and quality of life. The quality of life (QoL) is a psychometric outcome which is measured using validated questionnaires. Only few data are published concerning pre - and postoperative QoL.
This study investigated pre perative QoL of 185 patients who consecutively underwent open radical retropubic prostatectomy for organ-confined PCa to postoperative QoL of another 185 patients. The EORTC QLQ-C30, EORTC QLQPR25 module and 24 h ICS pad test were used (mean follow-up 28.6 months).
The examined symptom scores of the EORTC QLQ-PR25 were on lowest level. In the dyspnoea symptom score differences of age emerged: the amount of patients who are short of breath rose significantly in older patients after surgery (p < 0.05 paired, two-tailed student's t-test).. Lastly, the urinary symptom score was found postal-therapeutically low; this fact was age independent. The results of sexual symptom score need to be taken into consideration, since prostatectomy resulted in a significant reduction of sexual activity independent of age. All functioning scales postoperatively reached high values without significant changes (p > 0.05 student's t-test ), which implies a high QoL after surgery. A reliable and satisfying status of continence was found in our patients after retropubic prostatectomy. A high rate of patients (89.2%) would choose retropubic prostatectomy again.
Retropubic prostatectomy represents a reliable and accepted procedure in the treatment of organ-confined PCa. For the first time it could be shown that patients` QoL remained on a high level after retropubic prostatectomy. Nevertheless, the primary avoidance or postoperative therapy of erectile dysfunction should be in the focus of surgeons.
新诊断为早期局限性前列腺癌(PCa)的患者面临着具有治愈意图的不同治疗选择的艰难选择。他们必须同时考虑优化生活质量和数量的目标。生活质量(QoL)是一种通过经过验证的问卷进行测量的心理计量学结果。关于术前和术后生活质量的数据很少。
本研究调查了 185 例连续接受开放性根治性耻骨后前列腺切除术治疗局限性前列腺癌的患者的术前生活质量,以及 185 例接受手术的患者的术后生活质量。使用 EORTC QLQ-C30、EORTC QLQ-PR25 模块和 24 小时 ICS 垫试验(平均随访 28.6 个月)。
所检查的 EORTC PR25 症状评分处于最低水平。在呼吸困难症状评分中出现了年龄差异:手术后,呼吸急促的患者数量明显增加(p <0.05 配对,双侧学生 t 检验)。最后,术后尿症状评分较低,这一事实与年龄无关。需要考虑性功能症状评分,因为前列腺切除术导致与年龄无关的性活动显著减少。所有术后功能量表均达到高值而无显著变化(p >0.05 学生 t 检验),这意味着手术后生活质量较高。在我们的患者中,耻骨后前列腺切除术后发现控尿状态可靠且令人满意。有很高比例的患者(89.2%)会再次选择耻骨后前列腺切除术。
耻骨后前列腺切除术是治疗局限性前列腺癌的可靠且可接受的方法。首次表明,患者在耻骨后前列腺切除术后生活质量仍保持在较高水平。尽管如此,外科医生应将避免或术后治疗勃起功能障碍作为重点。