Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina.
Center for Health Measurement, Duke University School of Medicine, Durham, North Carolina.
Cancer. 2018 Jul 1;124(13):2832-2840. doi: 10.1002/cncr.31401. Epub 2018 Apr 16.
Men diagnosed with localized prostate cancer seek information on how treatment options may impact their health-related quality of life (HRQOL). The authors used latent profile analysis (LPA) to group men according to their symptom burden and functional status and to identify patient characteristics associated with each HRQOL profile.
Patients completed the Patient-Reported Outcomes Measurement Information System and the Expanded Prostate Index Composite measures 3 months after treatment initiation. Anxiety, depression, fatigue, sleep disturbance, pain, diarrhea, urinary obstruction, urinary incontinence, erectile function, and sex satisfaction were modeled jointly using LPA, and the analysis was adjusted for covariates to examine associations between patient characteristics and profiles.
One-third of the 373 men were not non-Hispanic white (26% were black). Four LPA profiles were identified. Men who experienced the "best HRQOL" were less likely to receive treatment, to be older, and to smoke. Men in the second best profile experienced symptoms similar to men in the best HRQOL group but reported poor sexual and urinary function, because they were more likely to receive therapy. The third profile included men with increased symptom burden and poor functioning who were likely to undergo prostatectomy and to have increased comorbidity. The "worst HRQOL" group experienced the worst symptoms and the poorest functioning, and these men were more likely to be younger, to have more comorbidities, and to smoke.
LPA revealed that men who receive the same treatment can experience very different HRQOL impact. Understanding the factors most associated with poorer HRQOL allows clinicians to focus their care on individuals most in need of symptom management and support. Cancer 2018;124:2832-2840. © 2018 American Cancer Society.
被诊断为局限性前列腺癌的男性寻求有关治疗选择如何影响其健康相关生活质量（HRQOL）的信息。作者使用潜在剖面分析（LPA）根据男性的症状负担和功能状态对其进行分组，并确定与每个 HRQOL 特征相关的患者特征。
患者在治疗开始后 3 个月完成了患者报告的结果测量信息系统和扩展前列腺指数综合测量。使用 LPA 联合对焦虑、抑郁、疲劳、睡眠障碍、疼痛、腹泻、尿路梗阻、尿失禁、勃起功能和性满意度进行建模，并对协变量进行调整，以检查患者特征与特征之间的关联。
373 名男性中，有三分之一不是非西班牙裔白人（26%是黑人）。确定了四个 LPA 特征。经历“最佳 HRQOL”的男性接受治疗的可能性较小，年龄较大，吸烟的可能性也较小。第二组表现良好的男性经历的症状与表现最佳 HRQOL 组的男性相似，但报告性功能和尿功能较差，因为他们更有可能接受治疗。第三个特征包括症状负担增加和功能不良的男性，他们更有可能接受前列腺切除术，并伴有更多的合并症。“最差 HRQOL”组经历了最严重的症状和最差的功能，这些男性更年轻，合并症更多，吸烟的可能性也更大。
LPA 表明，接受相同治疗的男性可能会经历非常不同的 HRQOL 影响。了解与较差 HRQOL 最相关的因素可以使临床医生将护理重点放在最需要症状管理和支持的个体上。癌症 2018;124:2832-2840。©2018 美国癌症协会。
