Maas M, Funk K, Stühler V, Walz S, Bahlburg H, Hennenlotter J, Bedke J, Aufderklamm S, Stenzl A, Tsaur I, Rausch Steffen
Department of Urology, University Hospital Tübingen, Eberhard Karls University, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany.
Department of Pediatrics and Neonatology, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.
J Cancer Res Clin Oncol. 2025 Sep 9;151(9):245. doi: 10.1007/s00432-025-06287-7.
High socioeconomic status (SES) is associated with improved oncological outcomes across various cancer types, including prostate cancer. However, limited evidence exists regarding the impact of SES and lifestyle factors on patient-reported outcomes (PROs), including quality of life (QoL), health status (HS), and functional recovery following radical prostatectomy (RP).
We conducted a retrospective single-center analysis of 327 patients undergoing RP (177 open, 150 robotic-assisted) assessing pre- and postoperative functional outcomes (QoL, HS, erectile function, continence). PROs were evaluated 24 months postoperatively. Correlations with sociodemographic, socioeconomic (ISEI-based SES, marital status, occupational status, hometown size), and lifestyle factors (physical activity, BMI, mental stress) were analyzed.
Pathological features of locally advanced tumors correlated negatively with QoL and HS. Higher SES was significantly associated with improved continence, but not with QoL, HS, or erectile function. Pre-existing mental stress negatively affected both continence and HS. Regular physical activity correlated positively with QoL and HS. Multivariable regression confirmed these findings and identified mental stress, SES, partnership and physical activity as independent predictors of PROs.
Beyond adverse tumor pathology, mental stress adversely impacts functional recovery and subjective health. In contrast, physical activity and a stable partnership correlate with better PROs. These findings may inform personalized patient counseling to increase postoperative satisfaction.
高社会经济地位(SES)与包括前列腺癌在内的多种癌症类型的肿瘤学预后改善相关。然而,关于SES和生活方式因素对患者报告结局(PROs)的影响,包括生活质量(QoL)、健康状况(HS)以及根治性前列腺切除术(RP)后的功能恢复,证据有限。
我们对327例行RP的患者(177例开放手术,150例机器人辅助手术)进行了一项回顾性单中心分析,评估术前和术后的功能结局(QoL、HS、勃起功能、控尿功能)。术后24个月评估PROs。分析了与社会人口统计学、社会经济因素(基于国际社会经济地位指数的SES、婚姻状况、职业状况、家乡规模)和生活方式因素(身体活动、体重指数、精神压力)的相关性。
局部晚期肿瘤的病理特征与QoL和HS呈负相关。较高的SES与控尿功能改善显著相关,但与QoL、HS或勃起功能无关。既往存在的精神压力对控尿功能和HS均有负面影响。规律的身体活动与QoL和HS呈正相关。多变量回归证实了这些发现,并确定精神压力、SES、伴侣关系和身体活动是PROs的独立预测因素。
除了不良的肿瘤病理外,精神压力对功能恢复和主观健康有不利影响。相比之下,身体活动和稳定的伴侣关系与更好的PROs相关。这些发现可能为个性化的患者咨询提供依据,以提高术后满意度。