Background factors and short-term health-related quality of life in patients who initially underwent radical prostatectomy or androgen deprivation therapy for localized prostate cancer in a Japanese prospective observational study (J-CaP Innovative Study-1)

Satoru Ueno; Yasuhide Kitagawa; Mizuki Onozawa; Shiro Hinotsu; Hideyuki Akaza; Atsushi Mizokami; Mikio Namiki

doi:10.1016/j.prnil.2017.05.004

Background factors and short-term health-related quality of life in patients who initially underwent radical prostatectomy or androgen deprivation therapy for localized prostate cancer in a Japanese prospective observational study (J-CaP Innovative Study-1)

Prostate Int. 2018 Mar;6(1):7-11. doi: 10.1016/j.prnil.2017.05.004. Epub 2017 Jun 3.

Authors

Satoru Ueno¹, Yasuhide Kitagawa¹, Mizuki Onozawa², Shiro Hinotsu³, Hideyuki Akaza⁴, Atsushi Mizokami¹, Mikio Namiki¹

Affiliations

¹ Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
² Department of Urology, Tokyo-kita Medical Center, Tokyo, Japan.
³ Center of Innovative Clinical Medicine, Okayama University, Okayama, Japan.
⁴ Department of Strategic Investigation on Comprehensive Cancer Network Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.

Abstract

Background: This prospective observational study elucidated the usefulness of hormonal therapy for localized prostate cancer. Background factors and the health-related quality of life in patients who initially underwent radical prostatectomy (RP) or primary androgen deprivation therapy (PADT) for localized prostate cancer are summarized.

Materials and methods: Patients aged 67-76 years with clinical stage T1c or T2 localized prostate cancer treated with PADT or RP, a prostate-specific antigen concentration of <20 ng/mL, and Gleason score of ≤7 were included. Health-related quality of life results estimated by the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8) and the Expanded Prostate Cancer Index Composite (EPIC) were investigated.

Results: In total, 850 patients who underwent RP and 370 patients who underwent PADT were enrolled. The proportion of patients with comorbidities of hypertension, cardiovascular disease, and/or cerebrovascular disease was greater in the PADT group than in the RP group. The proportion of patients deciding on treatment was significantly higher in the PADT group than in the RP group. In the RP group, the scores of many SF-8 and EPIC domains decreased at 3 months following surgery and returned to baseline levels at 1 year. In the PADT group, several domains gradually decreased during the year after treatment initiation. The proportion of patients with decreased satisfaction scores at 1 year compared with baseline was lower in the PADT group than that in the RP group.

Conclusion: Treatment risk influenced decisions on primary treatment for localized prostate cancer. Although there was a selection bias, short-term overall satisfaction in the PADT group was superior to that in the RP group in this clinical study.

Keywords: Androgen deprivation therapy; Prostate cancer; Prostatectomy; Quality of life.