Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer

(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related qual...

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Auteurs principaux:	Michael Chaloupka, Lina Stoermer, Maria Apfelbeck, Alexander Buchner, Vera Wenter, Christian G. Stief, Thilo Westhofen, Alexander Kretschmer
Format:	article
Langue:	EN
Publié:	MDPI AG 2021
Sujets:	cytoreductive HRQOL metastatic prostate cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Accès en ligne:	https://doaj.org/article/3ca5dee5decf47b2b8a86b57455899e3
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spelling	oai:doaj.org-article:3ca5dee5decf47b2b8a86b57455899e32021-11-25T17:01:55ZHealth-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer10.3390/cancers132256362072-6694https://doaj.org/article/3ca5dee5decf47b2b8a86b57455899e32021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5636https://doaj.org/toc/2072-6694(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (<i>n</i> = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (<i>n</i> = 79 with oligo-metastatic bone disease (cM1-oligo) and <i>n</i> = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, <i>p</i> = 0.186), and at time of follow-up (44% vs. 56%, <i>p</i> = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, <i>p</i> = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, <i>p</i> = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, <i>p</i> = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, <i>p</i> = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, <i>p</i> = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.Michael ChaloupkaLina StoermerMaria ApfelbeckAlexander BuchnerVera WenterChristian G. StiefThilo WesthofenAlexander KretschmerMDPI AGarticlecytoreductiveHRQOLmetastatic prostate cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5636, p 5636 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cytoreductive HRQOL metastatic prostate cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	cytoreductive HRQOL metastatic prostate cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Michael Chaloupka Lina Stoermer Maria Apfelbeck Alexander Buchner Vera Wenter Christian G. Stief Thilo Westhofen Alexander Kretschmer Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
description	(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (<i>n</i> = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (<i>n</i> = 79 with oligo-metastatic bone disease (cM1-oligo) and <i>n</i> = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, <i>p</i> = 0.186), and at time of follow-up (44% vs. 56%, <i>p</i> = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, <i>p</i> = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, <i>p</i> = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, <i>p</i> = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, <i>p</i> = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, <i>p</i> = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.
format	article
author	Michael Chaloupka Lina Stoermer Maria Apfelbeck Alexander Buchner Vera Wenter Christian G. Stief Thilo Westhofen Alexander Kretschmer
author_facet	Michael Chaloupka Lina Stoermer Maria Apfelbeck Alexander Buchner Vera Wenter Christian G. Stief Thilo Westhofen Alexander Kretschmer
author_sort	Michael Chaloupka
title	Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
title_short	Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
title_full	Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
title_fullStr	Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
title_full_unstemmed	Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer
title_sort	health-related quality of life following cytoreductive radical prostatectomy in patients with de-novo oligometastatic prostate cancer
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3ca5dee5decf47b2b8a86b57455899e3
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Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with De-Novo Oligometastatic Prostate Cancer

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