Impact of radical prostatectomy and radiotherapy on the quality of life of patients with localized prostate cancer

Abstract

Objectives: The evaluation of quality of life associated with different treatments in patients with prostate cancer is a key factor in making informed therapeutic decisions. Nevertheless, results in clinical practice are heterogeneous and insufficient. 

Material and methods: A prospective, observational study was conducted on patients that were going to begin treatment with external beam radiotherapy or laparoscopic radical prostatectomy (LPR) due to localized prostate cancer. The EPIC-CP quality of life questionnaire was completed before starting treatment (baseline) and then 6, 12, and 24 months after treatment.

Results: Fifty-nine patients were included in the analysis: 34 (58%) underwent radical prostatectomy and 25 (42%) received radiotherapy. Mean quality of life worsened in the two treatment groups and in all the domains. Maximum decline was at 6 months, and normal scores were recovered at 24 months. At months 6 and 12 after treatment, the percentage of patients that experienced a minimal important difference in quality of life was significantly higher in the LPR group than in the radiotherapy group for the incontinence and sexual function domains. There was no difference between the two groups at 24 months.  

Discussion: Minimal important difference could be calculated using the EPIC-CP questionnaire, thus facilitating the clinical interpretation of the results.  

Conclusions: At the medium term, LPR and radiotherapy had a different impact on the quality of life associated with incontinence and sexual function. At 24 months after treatment, quality of life was restored, regardless of treatment.