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A matter of size? Health‐related quality of life after radical prostatectomy for patients with giant prostates
Author(s) -
Westhofen Thilo,
Buchner Alexander,
Schlenker Boris,
Becker Armin,
Chaloupka Michael,
Bischoff Robert,
Stief Christian G.,
Kretschmer Alexander
Publication year - 2021
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.24124
Subject(s) - medicine , prostatectomy , hazard ratio , prostate cancer , confidence interval , odds ratio , quality of life (healthcare) , proportional hazards model , biochemical recurrence , urology , clinical endpoint , surgery , cancer , clinical trial , nursing
Background Evidence regarding the impact of giant prostate volume (PV) on outcome after radical prostatectomy (RP) is controversial with a lack of evidence on the impact of PV on health‐related quality of life (HRQOL). We aimed to assess the impact of giant PV on HRQOL and functional outcomes for men with prostate cancer (PC) undergoing RP. Methods Giant PV was defined based on the 95th percentile of PV measured by specimen weight of 3929 patients that underwent RP between 2013 and 2018 in a large tertiary care center. A propensity score‐matched analysis of 929 men treated with RP for PC ( n = 184 with PV ≥ 100 cm 3 , n = 745 with PV < 100 cm 3 ) was conducted. Primary endpoint was the impact of giant PV on HRQOL (based on EORTC QLQ‐C30) assessed with binary logistic regression and Cox proportional hazard model. Secondary endpoint was the impact of PV on oncological‐ and functional outcome. Results Median follow‐up was 24 months. Median PV, measured by specimen‐weight, was 58 cm 3 . We found no significant differences in median general HRQOL ( p = .183), giant PV was not associated with better HRQOL (odds ratio [OR], 1.54; 95% confidence interval [CI], 0.96–2.47; p = .075). No significant differences were found regarding continence recovery (hazard ratio [HR], 0.956; 95% CI, 0.771–1.185; p = .682), median International Consultation of Incontinence Questionnaire–Short‐Form (ICIQ‐SF) scores ( p = .062) or potency rates ( p = .151). Giant PV did not significantly impair biochemical recurrence‐free survival (HR, 0.968; 95% CI, 0.651–1.439; p = .871). Conclusions For patients undergoing RP, giant PV was not associated with adverse HRQOL outcomes. We found no significant impact of PV on continence rates, potency rates, and biochemical recurrence‐free survival. Hence, RP is an efficient cancer treatment for men even with giant PV.