Centre François Baclesse, Caen, France
Anne-Valérie Guizard , Clarisse Kerleau , Pascale Grosclaude , Mariette Mercier , Natacha Heutte , Florence Joly
Background: If treatments can cure localized prostate cancers (LPC) they often induce acute toxicities and definitive sequelae with impact on quality of life (QoL). However, very few studies focused on the long-term QoL of survivors of LPC. The goal of this population based case-control-study was to evaluate QoL 10 years after treatments for LPC in comparison with aged-matched healthy controls. Methods: LPC patients diagnosed in 2001 were issued from 11 French Cancer Registries. Controls were recruited among the general population and were matched to patients on age and geographic area. EORTC QLQ-C30, EPIC, HADS and MFI self-reported questionnaires were used to measure QoL, anxiety and fatigue. Patients were identified into 3 groups according to previews treatments: radical prostatectomy (RP), radiotherapy (RT) and radical prostatectomy plus radiotherapy (RP+RT). Patients could receive hormonotherapy (HT). Student’s paired t and McNemar χ² tests were used for the analysis between patients and controls. Analysis between treatments groups were performed with ANOVA. Only clinically relevant QoL score differences (≥ 5 points) were reported. Results: There were 287 patients and 287 controls. The participation rate of patients was of 46. Among LPC patients 143 (50%) were treated with RP, 78 (27%) with RT and 33 (11%) with RP+RT. 60 (21%) and 47 patients (16%) received HT at baseline and at the time of the study respectively. There was no socio-demographic difference between patients and controls. Patients didn’t report more anxiety, depression and fatigue than controls, but lower EORTC-QLQ social functioning score (p=0.003). LPC long-term survivors reported more urinary troubles (urinary function and incontinence) (p<0.0001) and more sexual dysfunctions (p<0.0001) than controls, whatever the treatment group. RP and RP+RT groups had worse urinary function and incontinence than RT (p<0.01). LPC survivors treated with HT at the time of study reported more sexual dysfunction (p<0.0001) and hormonal troubles (dysfunction and bother) (p=0.002) than the other survivors. Conclusions: 10 years after treatments, long term survivors of LPC reported important urinary and sexual dysfunctions with poor social QoL.
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