TY - JOUR
T1 - Predictors of health-related quality of life and adjustment to prostate cancer during active surveillance
AU - Bellardita, Lara
AU - Rancati, Tiziana
AU - Alvisi, Maria Francesca
AU - Villani, Daniela
AU - Magnani, Tiziana
AU - Marenghi, Cristina
AU - Nicolai, Nicola
AU - Procopio, Giuseppe
AU - Villa, Sergio
AU - Salvioni, Roberto
AU - Valdagni, Riccardo
PY - 2013/7
Y1 - 2013/7
N2 - Background: Active surveillance (AS) is emerging as an alternative approach to limit the risk of overtreatment and impairment of quality of life (QoL) in patients with low-risk localised prostate cancer. Although most patients report high levels of QoL, some men may be distressed by the idea of living with untreated cancer. Objective: To identify factors associated with poor QoL during AS. Design, setting, and participants: Between September 2007 and March 2012, 103 patients participated in the Prostate Cancer Research International Active Surveillance (PRIAS) QoL study. Mental health (Symptom Checklist-90), demographic, clinical, and decisional data were assessed at entrance in AS. Health-related QoL (HRQoL) Functional Assessment of Cancer Therapy-Prostate version and Mini-Mental Adjustment to Cancer outcomes were assessed after 10 mo of AS. Outcome measurements and statistical analysis: Multivariate logistic regression models were used to identify predictors of low (18 core specimens (OR: 0.89; p = 0.029) were predictors of better QoL. Limitations of this study were the small sample size and the lack of a control group. Conclusions: Factors predicting poor QoL were lack of a partner, impaired mental health, recent diagnosis, influence of clinicians and lower number of core samples taken at diagnostic biopsy. Educational support from physicians and emotional/social support should be promoted in some cases to prevent poor QoL.
AB - Background: Active surveillance (AS) is emerging as an alternative approach to limit the risk of overtreatment and impairment of quality of life (QoL) in patients with low-risk localised prostate cancer. Although most patients report high levels of QoL, some men may be distressed by the idea of living with untreated cancer. Objective: To identify factors associated with poor QoL during AS. Design, setting, and participants: Between September 2007 and March 2012, 103 patients participated in the Prostate Cancer Research International Active Surveillance (PRIAS) QoL study. Mental health (Symptom Checklist-90), demographic, clinical, and decisional data were assessed at entrance in AS. Health-related QoL (HRQoL) Functional Assessment of Cancer Therapy-Prostate version and Mini-Mental Adjustment to Cancer outcomes were assessed after 10 mo of AS. Outcome measurements and statistical analysis: Multivariate logistic regression models were used to identify predictors of low (18 core specimens (OR: 0.89; p = 0.029) were predictors of better QoL. Limitations of this study were the small sample size and the lack of a control group. Conclusions: Factors predicting poor QoL were lack of a partner, impaired mental health, recent diagnosis, influence of clinicians and lower number of core samples taken at diagnostic biopsy. Educational support from physicians and emotional/social support should be promoted in some cases to prevent poor QoL.
KW - Active surveillance
KW - Adjustment to cancer
KW - Coping
KW - Prostate cancer
KW - Quality of life
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U2 - 10.1016/j.eururo.2013.01.009
DO - 10.1016/j.eururo.2013.01.009
M3 - Article
C2 - 23357351
AN - SCOPUS:84878828115
VL - 64
SP - 30
EP - 36
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 1
ER -