Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
Departments of Mathematics and Life Science Systems, Munich Data Science Institute, Technical University of Munich, Garching, Germany.
Cancer Med. 2023 Feb;12(4):4842-4851. doi: 10.1002/cam4.5304. Epub 2022 Oct 18.
Prostate cancer (PC)-related anxiety is associated with clinically significant declines in health-related quality of life (HRQoL) and psychological well-being. This longitudinal study investigates course and predictors of PC-related anxiety in long-term PC survivors treated by radical prostatectomy (RP).
Two thousand nine hundred and three survivors from the multicenter German Familial PC Database completed the Memorial Anxiety Scale for PC on average 11 years after RP at the initial assessment in 2015 and then 5 years later. Hierarchical multiple linear regression was used to assess predictors of PC-related anxiety at follow-up.
PC-related anxiety remained stable over the 5 years. In hierarchical multiple linear regression, longitudinal predictors of PC-related anxiety 5 years later included a lower level of education (beta: -0.035, p = 0.019), biochemical recurrence (BCR; beta: 0.054, p = 0.002), late BCR (beta: 0.054, p < 0.001), PC anxiety at initial assessment (beta: 0.556, p < 0.001), HRQoL (beta: -0.076, p < 0.001), depression and anxiety symptoms (beta: 0.072, p = 0.001; beta: 0.165, p < 0.001). Predictors of prostate-specific antigen (PSA) anxiety 5 years later included late BCR (beta: 0.044, p = 0.019), PSA anxiety at initial assessment (beta: 0.339, p < 0.001), depression and anxiety symptoms (beta: 0.074, p = 0.008; beta: 0.191, p < 0.001), and treatment decision regret (beta: 0.052, p = 0.006).
PC-related anxiety remains a burden to survivors many years after diagnosis and treatment. The respective disease-specific anxiety was the strongest predictor of this anxiety 5 years later, which emphasizes the need of screening and monitoring in a timely manner for PC-related anxiety. Treating urologists should screen, identify, and monitor patients at risk for targeted referrals to psychosocial services.
前列腺癌（PC）相关焦虑与健康相关生活质量（HRQoL）和心理健康的临床显著下降有关。这项纵向研究调查了根治性前列腺切除术（RP）治疗的长期 PC 幸存者中 PC 相关焦虑的过程和预测因素。
293 名来自德国家族性前列腺癌数据库的幸存者在 RP 后平均 11 年（2015 年初始评估时），然后在 5 年后完成了前列腺癌焦虑量表的测试。采用分层多元线性回归分析来评估随访时 PC 相关焦虑的预测因素。
PC 相关焦虑在 5 年内保持稳定。在分层多元线性回归中，5 年后 PC 相关焦虑的纵向预测因素包括较低的教育水平（β：-0.035，p=0.019）、生化复发（BCR；β：0.054，p=0.002）、晚期 BCR（β：0.054，p<0.001）、初始评估时的 PC 焦虑（β：0.556，p<0.001）、HRQoL（β：-0.076，p<0.001）、抑郁和焦虑症状（β：0.072，p=0.001；β：0.165，p<0.001）。5 年后 PSA 相关焦虑的预测因素包括晚期 BCR（β：0.044，p=0.019）、初始评估时的 PSA 焦虑（β：0.339，p<0.001）、抑郁和焦虑症状（β：0.074，p=0.008；β：0.191，p<0.001）以及治疗决策后悔（β：0.052，p=0.006）。
PC 相关焦虑在诊断和治疗后多年仍然是幸存者的负担。特定于疾病的焦虑是 5 年后该焦虑的最强预测因素，这强调了及时进行筛查和监测的必要性。治疗泌尿科医生应筛查、识别和监测有风险的患者，以便有针对性地转介到心理社会服务机构。
