The following is a summary of “Impact of Preoperative LUTS on Health-Related Quality of Life following Radical Prostatectomy – A Propensity Score Matched Longitudinal Study,” published in the April 2024 issue of Urology by Westhofen et al.
This study aimed to evaluate the enduring effects of preoperative lower urinary tract symptoms (LUTS) on long-term health-related quality of life (HRQOL) following radical prostatectomy (RP) for prostate cancer (PC), extending up to a decade post-surgery. Within the prospective institutional database encompassing 6487 patients treated with RP for PC between 2008 and 2020, 2727 individuals presenting preoperative LUTS (as indicated by an International Prostate Symptom Score [IPSS] of ≥8) were identified. Employing a 1:1 propensity-score matched analysis of 3056 men (comprising 1528 with preoperative LUTS and 1528 without), the researchers assessed HRQOL utilizing the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and its prostate cancer-specific module (PR25).
The primary endpoint was the evaluation of HRQOL, with linear regression models utilized to discern the impact of preoperative LUTS on the net change in general HRQOL, with a significance level set at p-value <0.05. The findings, based on a median follow-up period of 48 months, revealed that preoperative mean global health status (GHS) scores were significantly lower in the LUTS cohort compared to those without LUTS (67.4 vs. 75.7, p < 0.001). Subsequent to RP, the disparity in general HRQOL between the LUTS and non-LUTS cohorts decreased yet remained statistically significant (65.7 vs. 67.8, p = 0.037). However, in the long-term follow-up, general HRQOL demonstrated comparability between both subcohorts (p-range 0.716 – 0.876). Multivariable linear regression analysis further identified increased preoperative IPSS as an independent predictor for enhanced perioperative improvement of IPSS (p < 0.001).
In conclusion, the findings suggest that preoperative LUTS was associated with a subsequent postoperative amelioration in HRQOL outcomes for patients undergoing RP. Moreover, in the long-term, HRQOL levels were comparable to those of patients without preoperative LUTS. Therefore, RP emerges as an efficient therapeutic option not only for the management of PC but also for alleviating associated LUTS in affected patients.
Source: sciencedirect.com/science/article/pii/S0090429524002899
