Health-Related Quality of Life and Survival in Prostate Cancer Patients in a Real-World Setting

Urol Int. 2020;104(11-12):939-947. doi: 10.1159/000510319. Epub 2020 Sep 21.


Objective: To analyze the health-related quality of life (HRQoL) and survival of real-world prostate cancer (PC) patients and to calculate quality-adjusted life-years (QALYs) experienced under different treatment strategies.

Materials and methods: PC patients undergoing active surveillance (n = 226), radiation treatment (n = 280), surgery (n = 299), or hormonal treatment (n = 62) responded to the generic 15-dimensional (15D) HRQoL questionnaire at the time of the diagnosis and were followed up 3, 6, 12, and 24 months later. QALYs experienced during the follow-up were calculated for each treatment group, and variables associated with survival were analyzed using Cox proportional hazards models.

Results: HRQoL was stable during the first 2 years after diagnosis in all other treatment groups, except in patients treated with hormonal therapy. The overall survival within 6.5-year follow-up time was 84.4%. The number of QALYs experienced during the 2-year follow-up was similar in patients in active surveillance (1.790), surgery (1.784), and radiation groups (1.767), but significantly lower in the hormonal therapy group (1.665).

Conclusions: Patients receiving hormonal treatment had significantly impaired HRQoL and survival compared with other treatments. Although the number of QALYs experienced was similar in the 3 other treatment lines, there were marked differences between treatment lines on some 15D dimensions.

Keywords: Fifteen dimensions; Health-related quality of life; Prostate cancer; Quality-adjusted life-year; Survival.

MeSH terms

  • Aged
  • Humans
  • Male
  • Prostatic Neoplasms / mortality*
  • Prostatic Neoplasms / therapy*
  • Quality of Life*
  • Retrospective Studies
  • Survival Rate