Presentation Authors: Jason Frankel*, Katherine Levie, Fernando Caumont, Seattle, WA, Claire Kuo, Rockville, MD, Timothy Brand, Tacoma, WA, Inger Rosner, Bethesda, MD, Sean Stroup, San Diego, CA, John Musser, Honolulu, HI, John Paul Flores, Seattle, WA, Jennifer Cullen, Rockville, MD, Christopher Porter, Seattle, WA
Introduction: Average age of prostate cancer (PCa) diagnosis is 66, with most men diagnosed between 65-74. Beyond National Cancer Comprehensive Network risk stratum, age is often used to determine the suitability of treatment options based on cancer control benefits. For aging men, health-related quality of life (HRQoL) concerns are crucial as oncologic survival outcomes can be difficult to predict. In this study, we examined the impact of age on HRQoL in men undergoing radical prostatectomy (RP).
Methods: A retrospective cohort study was conducted on enrollees in the Center for Prostate Disease Research (CPDR) Multi-center National Database diagnosed with PCa (2007-2013) and receiving RP as primary treatment. Expanded Prostate Cancer Index Composite and RAND 36 Item Short Form Health Survey questionnaires were completed pre-treatment and at regular follow up intervals. Patients with baseline HRQoL data baseline and â‰¥ 1 year follow up were included. Men without baseline or follow up data and men who received other treatments were excluded. Patients were grouped based on age at RP: < 60, 60-70, >70 yrs. Demographics, oncologic characteristics and HRQoL scores were obtained and compared across age groups. Multivariable generalized estimating equations were used to model change in HRQoL over time as a function of age group.
Results: 500 men met the inclusion criteria: 214 (42.8%) were < 60, 234 (46.8%) were 60-70, 52 (10.4%) were >70; mean follow up for each group was 4.9, 5.0, and 5.2 yrs respectively. Men aged 60-70 and >70 had significantly lower baseline sexual function (p < 0.0001), urinary bother (p=0.03) and sexual bother (p < 0.0001) scores vs. men < 60. No difference was found between groups in any other mental or physical HRQoL scores when adjusted for baseline HRQoL, risk category, race, comorbidities and time since treatment (Fig. 1). Men >70 had a significantly lower hormonal bother score than younger men (p=0.04).
Conclusions: HRQoL counseling is critical for men undergoing RP. This study shows that men >70 may experience greater hormonal bother than younger men undergoing RP. Otherwise, when baseline function is accounted for, no difference in HRQoL exists in older vs. younger men in this population. RP should be considered for all patients based on guidelines rather than age-based HRQoL concerns.
Source of Funding: This work was performed under the Cooperative Research Agreement Funds with Uniformed Services University for the Health Sciences. (Award # HU0001-10-2-0002)