Meissner Valentin H, Herkommer Kathleen, Marten-Mittag Birgitt, Gschwend Jürgen E, Dinkel Andreas
Department of Urology, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Langerstr. 3, 81675, Munich, Germany.
J Cancer Surviv. 2017 Dec;11(6):800-807. doi: 10.1007/s11764-017-0619-y. Epub 2017 May 21.
Knowledge of the psychological distress of long- and very long-term (>10 years) prostate cancer (PC) survivors is limited. This study intended to examine the parameters influencing anxiety related to prostate-specific antigen (PSA) and PC in long-term survivors after radical prostatectomy.
We surveyed 4719 PC survivors from the German multicenter prospective database "Familial Prostate Cancer." We evaluated the association of PC-related anxiety (MAX-PC) with sociodemographic characteristics, family history of PC, global health status/quality of life (EORTC QLQ-C30), depression and anxiety (PHQ-2; GAD-2), latest PSA level, time since radical prostatectomy, and current therapy.
The survey participants' mean age was 75.2 years (SD = 6.5). Median follow-up was 11.5 years, and 19.5% of participants had survived more than 15 years since the initial treatment. The final regression analysis found that younger age, lower global health status/quality of life, higher depression and anxiety scores, higher latest PSA level, and shorter time since radical prostatectomy predicted increased PSA-related anxiety and PC anxiety. Familial PC was predictive only of PSA anxiety (all p < 0.05). The final model explained 12% of the variance for PSA anxiety and 24% for PC anxiety.
PC-related anxiety remained relevant many years after prostatectomy and was influenced by younger age, psychological status, rising PSA level, and shorter time since initial treatment.
Survivors with these characteristics are at increased risk of PC-related anxieties, which should be considered by the treating physician during follow-up.
对于长期和超长期（>10年）前列腺癌（PC）幸存者心理困扰的了解有限。本研究旨在探讨影响根治性前列腺切除术后长期幸存者中与前列腺特异性抗原（PSA）及PC相关焦虑的参数。
我们对来自德国多中心前瞻性数据库“家族性前列腺癌”的4719名PC幸存者进行了调查。我们评估了与PC相关的焦虑（MAX-PC）与社会人口学特征、PC家族史、总体健康状况/生活质量（EORTC QLQ-C30）、抑郁和焦虑（PHQ-2；GAD-2）、最新PSA水平、根治性前列腺切除术后的时间以及当前治疗之间的关联。
调查参与者的平均年龄为75.2岁（标准差=6.5）。中位随访时间为11.5年，19.5%的参与者自初始治疗后存活超过15年。最终回归分析发现，年龄较小、总体健康状况/生活质量较低、抑郁和焦虑评分较高、最新PSA水平较高以及根治性前列腺切除术后时间较短预示着与PSA相关的焦虑和PC焦虑增加。家族性PC仅可预测PSA焦虑（所有p<0.05）。最终模型解释了PSA焦虑方差的12%和PC焦虑方差的24%。
前列腺切除术后多年，与PC相关的焦虑仍然存在，并受到年龄较小、心理状态、PSA水平升高以及初始治疗后时间较短的影响。
具有这些特征的幸存者发生与PC相关焦虑的风险增加，治疗医生在随访期间应予以考虑。
