Maggi Martina, Gentilucci Alessandro, Salciccia Stefano, Gatto Antonio, Gentile Vincenzo, Colarieti Anna, Von Heland Magnus, Busetto Gian Maria, Del Giudice Francesco, Sciarra Alessandro
Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy.
Andrologia. 2019 Feb;51(1):e13157. doi: 10.1111/and.13157. Epub 2018 Oct 3.
Limited attention has been given to the psychological impact of primary treatments in patients with prostate cancer. Aim of our analysis was to critically analyse the current evidence on the psychological impact of different primary treatments (surgery, radiotherapy and active surveillance), in patients with prostate cancer, using validated questionnaires. We searched in the MEDLINE and Cochrane library database from the literature of the past 15 years (primary fields: prostate neoplasm, AND radical prostatectomy or radiotherapy or active surveillance AND psychological distress or anxiety or depression; secondary fields: urinary, sexual, bowel modifications, non-randomised and randomised trials). Overall eighteen original and review articles were included and critically evaluated. Either radical prostatectomy or active surveillance and radiotherapy are well-tolerated in terms of definite anxiety and depression during the post-treatment follow-up. A mutual influence between functional and psychological modifications induced by treatments has been demonstrated. Urinary symptoms related to incontinence more than sexual and bowel dysfunction are able to induce psychological distress worsening. In conclusion, patients and their clinicians might wish to know how functional and psychological aspects may differently be influenced by treatment choice.
前列腺癌患者接受的初始治疗对其心理影响方面受到的关注有限。我们分析的目的是使用经过验证的问卷，批判性地分析目前关于前列腺癌患者接受不同初始治疗（手术、放疗和主动监测）所产生心理影响的证据。我们在过去15年的文献中检索了MEDLINE和Cochrane图书馆数据库（主要领域：前列腺肿瘤，以及根治性前列腺切除术或放疗或主动监测以及心理困扰或焦虑或抑郁；次要领域：泌尿、性、肠道改变、非随机和随机试验）。总共纳入了18篇原创文章和综述文章并进行了批判性评估。在治疗后的随访期间，就明确的焦虑和抑郁而言，根治性前列腺切除术、主动监测和放疗的耐受性都很好。已经证明了治疗引起的功能和心理改变之间存在相互影响。与尿失禁相关的泌尿症状比性功能和肠道功能障碍更能导致心理困扰加剧。总之，患者及其临床医生可能希望了解治疗选择如何不同地影响功能和心理方面。
