Division of Urology, Taipei City Hospital, Taipei, Taiwan, ROC.
National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2019 Jun;82(6):482-487. doi: 10.1097/JCMA.0000000000000110.
Prostate cancer (PCa) is the most frequently diagnosed cancer and is becoming a growing concern in global epidemiology. Quality of life of patients has become a major outcome for cancer care but limited study investigated quality of life of PCa patients. Our study is to investigate predictors for treatment outcomes of lower urinary tract symptoms (LUTS), nocturia, and the urinary specific quality of life (uQoL) in PCa patients one year following treatment.
A prospective study of 131 consecutive patients was conducted with outcome measurements before treatment, at 3 months, 6 months, and one year following therapy. We utilized the International Prostate Symptom Score questionnaire to collect data. Generalized estimating equations were performed to identify predictors for major outcomes of LUTS, nocturia, and uQoL.
LUTS increased slightly over time, but nocturia and uQoL were improved from baseline to 12 months. Results of the interaction analysis indicated that patients with TNM stage 3 compared with those with stage 2 had a reduction in LUTS from diagnosis to 6 months. Patients who received surgery or radiation compared to hormone therapy had worse nocturia from diagnosis to 6 months compared to those of patients who received hormone therapy. Higher body mass index (BMI) decreased the uQoL from diagnosis to 3 months, and higher prostate-specific antigen (PSA) level deteriorated the uQoL from diagnosis to 12 months.
TNM stage and BMI affected the LUTS. Patients undergone a prostatectomy or radiation therapy showed more frequency of nocturia, BMI and PSA were also risk factors for nocturia. Moreover, patients' age, BMI, and PSA affected uQoL. In such patients, we recommend close monitoring of patients' specific characteristics such as TNM stage, BMI, and PSA for a better quality of life.
前列腺癌(PCa)是最常见的癌症,在全球流行病学中日益受到关注。患者的生活质量已成为癌症治疗的主要结果,但有限的研究调查了 PCa 患者的生活质量。我们的研究旨在调查治疗后一年内下尿路症状(LUTS)、夜尿症和前列腺癌患者的尿特异性生活质量(uQoL)的治疗结果的预测因素。
对 131 例连续患者进行了前瞻性研究,在治疗前、治疗后 3 个月、6 个月和 12 个月进行了结局测量。我们利用国际前列腺症状评分问卷收集数据。广义估计方程用于确定 LUTS、夜尿症和 uQoL 的主要结局的预测因素。
LUTS 随时间略有增加,但夜尿症和 uQoL 从基线到 12 个月有所改善。交互分析结果表明,与 II 期患者相比,III 期患者的 LUTS 从诊断到 6 个月有所减轻。与接受激素治疗的患者相比,接受手术或放疗的患者从诊断到 6 个月的夜尿症更严重。较高的体重指数(BMI)从诊断到 3 个月降低了 uQoL,较高的前列腺特异性抗原(PSA)水平从诊断到 12 个月恶化了 uQoL。
TNM 分期和 BMI 影响 LUTS。接受前列腺切除术或放疗的患者夜间尿频更为频繁,BMI 和 PSA 也是夜间尿频的危险因素。此外,患者的年龄、BMI 和 PSA 影响 uQoL。对于这些患者,我们建议密切监测患者的特定特征,如 TNM 分期、BMI 和 PSA,以提高生活质量。