Back to 2015 Joint Annual Meeting

Introduction:
A number of treatments for localized prostate cancer(CaP) exist, often with similar oncologic outcomes. As such, health related quality of life(HRQOL) plays a significant role in treatment decisions. We sought to evaluate the long-term HRQOL impact of four such treatments.
Materials and Methods:
Patients undergoing open/robotic-assisted radical prostatectomy(ORP/RAP), brachytherapy(BT), or cryotherapy(CRYO) for localized CaP between March 2002 and October 2009 were asked to complete the UCLA-PCI pre-op and at 1,3,6,12,18,24,30,36,48,and 60 months post-op. 586/1094 patients returned surveys out to 60 months. Outcomes were compared across treatments. Baseline scores were obtained along with percent of baseline scores(PBS) for all subsequent surveys.
Results:
For urinary function(UF) and bother(UB) domains, BT and CRYO showed significant improvement in HRQOL vs ORP or RAP, which persisted to the 60 months. BT and CRYO showed a faster return of HRQOL, plateauing by 6-12 months vs ORP and RAP which plateaued at 18-24 months. Sexual function(SF) and bother(SB) domains showed significantly improved HRQOL for BT over ORP, RAP, and CRYO. By 12 months, BT patients had roughly double the improvement of the others. BT, however, demonstrated a decline in SF after 36 months vs ORP, RAP, and CYRO which had stable SF over the same period.
Conclusions:
In patients followed to 5 years, BT and CRYO offer durable HRQOL benefits in both UF and UB over ORP and RAP. BT alone offers improved HRQOL outcomes for SF as compared to ORP, RAP, or CRYO. These findings can be employed for appropriate counseling prior to treatment decisions.