Quality of Life Outcomes after Primary Treatment for Clinically Localised Prostate Cancer: A Systematic Review

被引：200

作者：

Lardas, Michael ^{[1
]}

Liew, Matthew ^{[2
]}

van den Bergh, Roderick C. ^{[3
,4
,5
]}

De Santis, Maria

Bellmunt, Joaquim ^{[6
,7
]}

Van den Broeck, Thomas ^{[8
,9
]}

Cornford, Philip ^{[10
]}

Cumberbatch, Marcus G. ^{[11
]}

Fossati, Nicola ^{[12
,13
]}

Gross, Tobias ^{[14
]}

Henry, Ann M. ^{[15
,16
]}

Bolla, Michel ^{[17
]}

Briers, Erik

Joniau, Steven ^{[8
]}

Lam, Thomas B. ^{[18
,19
]}

Mason, Malcolm D. ^{[20
]}

Mottet, Nicolas ^{[21
]}

van der Poel, Henk G.

Rouviere, Olivier ^{[22
]}

Schoots, Ivo G. ^{[23
]}

Wiegel, Thomas ^{[24
]}

Willemse, Peter-Paul M. ^{[3
,25
]}

Yuan, Cathy Yuhong ^{[26
]}

Bourke, Liam ^{[27
]}

机构：

[1] Leto Hosp, Dept Urol, Athens, Greece

[2] Wigan & Leigh NHS Fdn Trust, Dept Urol, Wigan, England

[3] Netherlands Canc Inst, Dept Urol, Amsterdam, Netherlands

[4] Univ Warwick, Clin Trials Unit, Warwick, England

[5] Med Univ Vienna, Dept Urol, Vienna, Austria

[6] Dana Farber Canc Inst, Bladder Canc Ctr, Boston, MA 02115 USA

[7] Harvard Med Sch, Boston, MA USA

[8] Univ Hosp Leuven, Dept Urol, Leuven, Belgium

[9] Katholieke Univ Leuven, Lab Mol Endocrinol, Leuven, Belgium

[10] Royal Liverpool & Broadgreen Hosp NHS Trust, Liverpool, Merseyside, England

[11] Univ Sheffield, Acad Urol Unit, Sheffield, S Yorkshire, England

[12] IRCCS Osped San Raffaele, URI, Unit Urol, Div Oncol, Milan, Italy

[13] Univ Vita Salute San Raffaele, Milan, Italy

[14] Univ Bern, Inselspital, Dept Urol, Bern, Switzerland

[15] St James Univ Hosp, Leeds Canc Ctr, Leeds, W Yorkshire, England

[16] Univ Leeds, Leeds, W Yorkshire, England

[17] CHU Grenoble, Dept Radiat Therapy, Grenoble, France

[18] Univ Aberdeen, Acad Urol Unit, Aberdeen, Scotland

[19] Aberdeen Royal Infirm, Dept Urol, Aberdeen, Scotland

[20] Cardiff Univ, Sch Med, Wales Canc Bank, Cardiff, S Glam, Wales

[21] Univ Hosp, Dept Urol, St Etienne, France

[22] Hosp Civils Lyon, Radiol Dept, Edouard Herriot Hosp, Lyon, France

[23] Erasmus MC Univ Med Ctr, Dept Radiol & Nucl Med, Rotterdam, Netherlands

[24] Univ Hosp, Dept Radiat Oncol, Ulm, Germany

[25] Univ Groningen, Univ Med Ctr Groningen, Dept Urol, Groningen, Netherlands

[26] McMaster Univ, Dept Med, Hamilton, ON, Canada

[27] Sheffield Hallam Univ, Fac Hlth & Wellbeing, Sheffield, S Yorkshire, England

来源：

EUROPEAN UROLOGY | 2017年 / 72卷 / 06期

关键词：

Localised prostate cancer; Quality of life; Patient-reported outcome measures; Radical prostatectomy; Radiotherapy; Active surveillance; Brachytherapy; Systematic review; RADICAL PROSTATECTOMY; ACTIVE SURVEILLANCE; BRACHYTHERAPY; RADIOTHERAPY; MEN; THERAPY; DISEASE; SURGERY; IMPACT;

D O I：

10.1016/j.eururo.2017.06.035

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Context: Current evidence-based management for clinically localised prostate cancer includes active surveillance, surgery, external beam radiotherapy (EBRT) and brachy-therapy. The impact of these treatment modalities on quality of life (QoL) is uncertain. Objective: To systematically review comparative studies investigating disease-specific QoL outcomes as assessed by validated cancer-specific patient-reported outcome measures with at least 1 yr of follow-up after primary treatment for clinically localised prostate cancer. Evidence acquisition: MEDLINE, EMBASE, AMED, PsycINFO, and Cochrane Library were searched to identify relevant studies. Studies were critically appraised for the risk of bias. A narrative synthesis was undertaken. Evidence synthesis: Of 11 486 articles identified, 18 studies were eligible for inclusion, including three randomised controlled trials (RCTs; follow-up range: 60-72 mo) and 15 nonrandomised comparative studies (follow-up range: 12-180 mo) recruiting a total of 13 604 patients. Two RCTs recruited small cohorts and only one was judged to have a low risk of bias. The quality of evidence from observational studies was low to moderate. For a follow-up of up to 6 yr, active surveillance was found to have the lowest impact on cancer-specific QoL, surgery had a negative impact on urinary and sexual function when compared with active surveillance and EBRT, and EBRT had a negative impact on bowel function when compared with active surveillance and surgery. Data from one small RCT reported that brachytherapy has a negative impact on urinary function 1 yr post-treatment, but no significant urinary toxicity was reported at 5 yr. Conclusions: This is the first systematic review comparing the impact of different primary treatments on cancer-specific QoL for men with clinically localised prostate cancer, using validated cancer-specific patient-reported outcome measures only. There is robust evidence that choice of primary treatment for localised prostate cancer has distinct impacts on patients' QoL. This should be discussed in detail with patients during pretreatment counselling. (C) 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

引用

页码：869 / 885

页数：17

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