Retropubic RP results in high levels of patient satisfaction
MedWire News: The vast majority of men treated with open radical retropubic prostatectomy (RRP) for prostate cancer are satisfied with their treatment after 2 years, report US researchers.
However, those who do experience dissatisfaction do so in a time-dependent manner, with postoperative factors such as catheterization affecting short-term satisfaction, and sexual and urinary function affecting long-term satisfaction, says the team.
"While survival is universally recognized as the ultimate treatment outcome, health-related quality of life (HRQoL) is also important," say Herbert Lepor, from New York University School of Medicine, and colleagues.
The group investigated self-assessed satisfaction at 3, 6, 12, and 24 months after treatment in a cohort of 1542 RRP patients.
Baseline and post-RRP urinary and erectile functioning were assessed using a combination of the University of California at Los Angeles Prostate Cancer Index and the American Urological Association symptom index (AUASI), while satisfaction with RRP was based on a three-level response ("very satisfied," "satisfied," and "unsatisfied").
Approximately 93% of men were satisfied with their treatment at each follow-up point.
During the median 24-month follow-up, the men's post-treatment median urinary AUASI scores improved, rising from 58 (out of 100) at 3 months, to 75 at 6 months, 82 at 12 months, and 85 at 24 months. Sexual function scores were lower but followed the same trend, rising from 18 at 3 months to 21 at 6 months, 29 at 12 months, and 39 at 24 months after treatment.
After adjusting for potential confounding factors, the researchers found that men were 77% less likely to be satisfied with their RRP outcome at 3 months if their urinary catheter had been indwelling for 3 weeks or longer after RRP.
Requiring intervention for anastomotic stricture or experiencing a 4-point-from-baseline worsening on the AUASI also reduced the chances of satisfaction at 3 months, by 77% and 74%, respectively.
By 6 months, men were significantly less satisfied if their urinary score had worsened from baseline (odds ratio [OR]=0.34), or they had experienced biochemical failure (OR=0.15). Catheterization was no longer significant at this point, remark the researchers.
The 6-month satisfaction factors remained significant at 12 and 24 months, when a reduction in sexual functioning score also rendered men less satisfied with their RRP outcome.
"HRQoL and patient satisfaction with treatment may help guide the treatment choice in men with newly diagnosed prostate cancer," conclude Lepor et al in the Journal of Urology.
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By Sarah Guy