Impact of Age and Race on Health-Related Quality of Life Outcomes in Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

Natasza Posielski; Jason Frankel; Huai-Ching Kuo; On Ho; Sally Elsamanoudi; Darryl Nousome; Ryan Speir; Sean Stroup; John Musser; Alexander Ernest; Gregory T Chesnut; Timothy Tausch; John Paul Flores; Christopher Porter

doi:10.1016/j.urology.2021.07.034

Impact of Age and Race on Health-Related Quality of Life Outcomes in Patients Undergoing Radical Prostatectomy for Localized Prostate Cancer

Urology. 2022 May:163:99-106. doi: 10.1016/j.urology.2021.07.034. Epub 2021 Aug 22.

Authors

Affiliations

¹ Virginia Mason Franciscan Health, Seattle, WA.
² Virginia Mason Franciscan Health, Seattle, WA; Washington St. Louis University, St. Louis, MO.
³ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD.
⁴ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD.
⁵ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD; Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, MD.
⁶ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Madigan Army Medical Center, Tacoma, WA.
⁷ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Naval Medical Center, San Diego, CA.
⁸ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Tripler Army Medical Center, Honolulu, HI.
⁹ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Brooke Army Medical Center, Fort Sam Houston, TX.
¹⁰ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD; Walter Reed National Military Medical Center, Bethesda, MD.
¹¹ Walter Reed National Military Medical Center, Bethesda, MD.
¹² Virginia Mason Franciscan Health, Seattle, WA. Electronic address: Christopher.Porter@virginiamason.org.

PMID: 34428537
DOI: 10.1016/j.urology.2021.07.034

Abstract

Objectives: To investigate impact of age and race on health-related quality of life (HRQoL) in men undergoing radical prostatectomy (RP) using a prospectively maintained, racially diverse cohort.

Methods: The Center for Prostate Disease Research Multicenter National Database was used to identify patients receiving RP from 2007-2017. The Expanded PCa Index Composite and 36 Item Short-Form Health Survey were completed at baseline and regular intervals. Groups were stratified based on age: <60, 60-70, >70. Longitudinal patterns in HRQoL were assessed using linear regression models, adjusting for baseline HRQoL, demographics, and clinical characteristics.

Results: In 626 patients undergoing RP, 278 (44.4%) were <60, 291 (46.5%) were 60-70, 57 (9.1%) were >70. Older men had worse baseline urinary bother (P<.01) and sexual HRQoL (P<.01). Baseline urinary function was similar for older and younger men. Post-RP urinary and sexual HRQoL was significantly lower in men >70. However, when adjusting for baseline HRQoL, race, NCCN risk, and comorbidities, no difference was found between age groups in urinary function or bother, or sexual function. Sexual bother was worse in older men until 48 months post-operatively but subsequently improved to levels similar to younger patients. Race independently affected HRQoL outcomes with older African American men reporting worse urinary function and sexual bother.

Conclusions: When accounting for baseline HRQoL, age does not independently predict worse HRQoL outcomes. Older and younger men experience similar declines in urinary and sexual domain scores after RP. Our findings may be used to better inform patients regarding their expected post RP HRQoL and guide treatment decision-making.

Publication types

Multicenter Study

MeSH terms

Aged
Humans
Male
Prostate
Prostatectomy / adverse effects
Prostatic Neoplasms* / therapy
Quality of Life
Urination Disorders* / etiology