Jønler M, Nielsen O S, Wolf H
Department of Urology, Skejby Hospital, Arhus, Denmark.
Urology. 1998 Dec;52(6):1055-62; discussion 1063. doi: 10.1016/s0090-4295(98)00449-x.
To evaluate urinary symptoms, potency, and quality of life in a group of patients with prostate cancer followed up with deferred treatment.
A self-administered questionnaire was mailed to patients with localized prostate cancer who were followed up with deferred treatment. Data regarding clinical stage, pathologic grade, and treatment after diagnosis were obtained from patient files.
A total of 71 consecutive patients (age 79 years or less) were included. Of the 52 patients (73%) who responded, 31% had undergone transurethral resection of the prostate, 8% underwent radiation therapy, and 44% underwent hormonal deprivation during the follow-up period. With respect to incontinence, 21% were using pads and 37% leaked urine daily; in 21% of the patients, urine dripping or leaking was a substantial problem. Before the diagnosis of their prostate cancer, 81% stated they were able to have an erection. At the time of the questionnaire, 77% stated that their ability to have erections was reduced and only 29% had had an erection after the prostate cancer was diagnosed. For 12%, impotence was a problem. With respect to quality of life, 52% of the patients rated their health as excellent or good and 61% would be happy to spend the rest of their life feeling the way they did at the time of the questionnaire. Eighty-five percent were satisfied with the treatment policy for their prostate cancer, and 96% would choose deferred treatment again if faced with the decision.
By use of a self-administered questionnaire, a high frequency of incontinence and impotence was found in a group of patients with prostate cancer followed up with deferred treatment. Despite these problems, more than half of the patients rated their health as good and would undergo expectant management again if faced with the decision.
评估一组接受延迟治疗随访的前列腺癌患者的泌尿系统症状、性功能及生活质量。
向接受延迟治疗随访的局限性前列腺癌患者邮寄了一份自填式问卷。从患者病历中获取有关临床分期、病理分级及诊断后治疗的资料。
共纳入71例连续患者（年龄79岁及以下）。在52例（73%）回复问卷的患者中，31%在随访期间接受了经尿道前列腺切除术，8%接受了放射治疗，44%接受了激素剥夺治疗。关于尿失禁，21%的患者使用尿垫，37%的患者每天漏尿；21%的患者存在尿液滴沥或漏尿的严重问题。在诊断前列腺癌之前，81%的患者表示能够勃起。在填写问卷时，77%的患者表示勃起能力下降，前列腺癌诊断后只有29%的患者能够勃起。12%的患者存在阳痿问题。关于生活质量，52%的患者将自己的健康状况评为优秀或良好，61%的患者表示愿意以问卷填写时的状态度过余生。85%的患者对前列腺癌的治疗方案满意，96%的患者表示如果再次面临选择，仍会选择延迟治疗。
通过自填式问卷发现，一组接受延迟治疗随访的前列腺癌患者中，尿失禁和阳痿的发生率较高。尽管存在这些问题，但超过半数的患者将自己的健康状况评为良好，并且如果再次面临选择，仍会接受观察等待治疗。
