Prospective quality of life in men choosing open vs. robotic radical prostatectomy: long-term results from a racially diverse multi-institutional database

Eyal Kord¹, Nate Jung², Brock Boehm³, Galen Conti^{4

5}, Huai-Ching Kuo^{4

6

7}, Jason Frankel^{2

8}, John Flores², Katherine Levie^{2

4

9}, On Ho², Sally Elsamanoudi^{4

6}, Jiji Jiang^{4

6}, Sean P Stroup^{4

10}, John Musser^{4

11}, Alexander Ernest^{4

12}, Ryan Speir^{4

13}, Gregory Chesnut^{3

4}, Timothy J Tausch³, Christopher Porter²

Affiliations

¹ Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA. Eyalkord@gmail.com.
² Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA.
³ Walter Reed National Military Medical Center, Bethesda, MD, USA.
⁴ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁵ American Urogynecologic Society, Silver Spring, MD, USA.
⁶ The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
⁷ Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁸ Washington St. Louis University, St. Louis, MO, USA.
⁹ Syapse, Inc, San Francisco, CA, USA.
¹⁰ Naval Medical Center, San Diego, CA, USA.
¹¹ Tripler Army Medical Center, Honolulu, HI, USA.
¹² Brooke Army Medical Center, Fort Sam Houston, TX, USA.
¹³ Madigan Army Medical Center, Tacoma, WA, USA.

PMID: 35279731
DOI: 10.1007/s00345-022-03975-8

Multicenter Study

Prospective quality of life in men choosing open vs. robotic radical prostatectomy: long-term results from a racially diverse multi-institutional database

Eyal Kord et al. World J Urol. 2022 Jun.

. 2022 Jun;40(6):1427-1436.

doi: 10.1007/s00345-022-03975-8. Epub 2022 Mar 12.

Authors

Affiliations

¹ Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA. Eyalkord@gmail.com.
² Department of Urology, Virginia Mason Franciscan Health, Virginia Mason Hospital and Seattle Medical Center, 1100 Ninth Ave., Seattle, WA, USA.
³ Walter Reed National Military Medical Center, Bethesda, MD, USA.
⁴ Center for Prostate Disease Research, Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁵ American Urogynecologic Society, Silver Spring, MD, USA.
⁶ The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA.
⁷ Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁸ Washington St. Louis University, St. Louis, MO, USA.
⁹ Syapse, Inc, San Francisco, CA, USA.
¹⁰ Naval Medical Center, San Diego, CA, USA.
¹¹ Tripler Army Medical Center, Honolulu, HI, USA.
¹² Brooke Army Medical Center, Fort Sam Houston, TX, USA.
¹³ Madigan Army Medical Center, Tacoma, WA, USA.

PMID: 35279731
DOI: 10.1007/s00345-022-03975-8

Abstract

Purpose: To compare 5-year health-related quality of life (HRQoL) outcomes between prostate cancer (CaP) patients who underwent robotic-assisted laparoscopic radical prostatectomy (RALP) versus open radical retropubic prostatectomy (RRP) and assess for racial disparities between Caucasian American (CA) and African American (AA) men undergoing surgery.

Methods: A prospective cohort study of HRQoL data was conducted on patients diagnosed with CaP from 2007 to 2017 and enrolled in the Center for Prostate Disease Research (CPDR) Multicenter National Database. Using the EPIC and SF-36 instruments, changes in urinary, sexual, bowel, and hormonal domains, as well as physical and mental component summary scores were compared across surgery type (RALP versus RRP) at pre-treatment ("baseline"), and annually for 5 years. We further compared HRQoL outcomes in CA and AA men undergoing surgery. Longitudinal HRQoL patterns were modeled using generalized estimating equations (GEE), adjusting for baseline HRQoL and other characteristics.

Results: 448 CaP patients (22% AA) met study inclusion criteria, 66% underwent RALP and 34% underwent RRP. At baseline, HRQoL domains were comparable across treatment group (RALP vs. RRP). In the adjusted low-risk cohort, there were only three time points that met a statistically significant HRQoL difference in EPIC scores between RALP and RRP. Urinary function score during year 4 of follow-up showed a 7.5 (95% CI 3.1-11.9, P = 0.01) points difference in favor of RRP. Bowel bother scores favored RRP in year 1 with a difference of 3.1 (95% CI 0.7-5.4, P = 0.04) points, and in year 5 with a difference of 3.8 (95% CI 1.1-6.4, P = 0.03) points. In the intermediate/high-risk cohort, there were no statistically significant differences in any of the domain scores between RALP and RRP during follow-up.

Conclusions: The robotic and open approach to radical prostatectomy led to comparable HRQoL outcomes at a follow-up length of 60 months. No HRQoL racial disparities were found between AA and CA men during long-term follow-up.

Keywords: Prostate cancer; Quality of life; Radical prostatectomy.

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References

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Prospective quality of life in men choosing open vs. robotic radical prostatectomy: long-term results from a racially diverse multi-institutional database

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Prospective quality of life in men choosing open vs. robotic radical prostatectomy: long-term results from a racially diverse multi-institutional database

Authors

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Abstract

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Full Text Sources

Medical

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