Clinical Use of Expanded Prostate Cancer Index Composite for Clinical Practice to Assess Patient Reported Prostate Cancer Quality of Life Following Robot-Assisted Radical Prostatectomy

J Urol. 2017 Jan;197(1):109-114. doi: 10.1016/j.juro.2016.07.080. Epub 2016 Jul 27.

Abstract

Purpose: EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) is a short questionnaire that comprehensively measures patient reported health related quality of life at the point of care. We evaluated the feasibility of using EPIC-CP in the routine clinical care of patients with prostate cancer without research infrastructure. We compared longitudinal patient and practitioner reported prostate cancer outcomes.

Materials and methods: We reviewed health related quality of life outcomes in 482 patients who underwent radical prostatectomy at our institution from 2010 to 2014. EPIC-CP was administered and interpreted in routine clinical practice without research personnel. We compared practitioner documented rates of incontinence pad use and functional erections to patient reported rates using EPIC-CP.

Results: A total of 708 EPIC-CP questionnaires were completed. Mean urinary incontinence domain scores were significantly higher (worse) than baseline (mean ± SD 0.6 ± 0.2) 3 and 6 months after treatment (mean 3.1 ± 2.3 and 2.2 ± 2.1, respectively, each p <0.05) but they returned to baseline at 12 months (mean 1.6 ± 1.7, p >0.05). Mean sexual domain scores were significantly worse than baseline (mean 2.4 ± 2.8) at all posttreatment time points (each p <0.05). Practitioners significantly overestimated incontinence pad-free rates at 3 months (48% vs 39%) and functional erection rates at 3 months (18% vs 12%), 6 months (38% vs 23%) and 12 months (45% vs 23%, each p <0.05).

Conclusions: EPIC-CP is feasible to use in the routine clinical care of patients with prostate cancer without requiring a research infrastructure. Using EPIC-CP in clinical practice may help practitioners objectively assess and appropriately manage posttreatment side effects in patients with prostate cancer.

Keywords: outcome assessment (health care); patient-centered care; prostatic neoplasms/therapy; quality of life; questionnaires.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Erectile Dysfunction / etiology
  • Erectile Dysfunction / physiopathology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Grading
  • Patient Reported Outcome Measures*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Practice Patterns, Physicians' / standards
  • Predictive Value of Tests
  • Prostatectomy / adverse effects
  • Prostatectomy / methods*
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / psychology
  • Prostatic Neoplasms / surgery*
  • Quality of Life*
  • Retrospective Studies
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Surveys and Questionnaires*
  • United States
  • Urinary Incontinence / etiology
  • Urinary Incontinence / physiopathology