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  • Title: Health related quality of life and direct medical care cost in newly diagnosed younger men with prostate cancer.
    Author: Jayadevappa R, Bloom BS, Chhatre S, Fomberstein KM, Wein AJ, Malkowicz SB.
    Journal: J Urol; 2005 Sep; 174(3):1059-64; discussion 1064. PubMed ID: 16094058.
    Abstract:
    PURPOSE: We evaluated health related quality of life (HRQOL) and the direct medical care cost (DMC) in young men receiving radical prostatectomy. MATERIALS AND METHODS: In this prospective cohort study, 40 newly diagnosed patients with prostate cancer (PCa) who were younger than 65 years were matched with 40 cancer-free men. Participants completed the Medical Outcome Study Short Form and UCLA-PCa Index surveys prior to treatment, and at 3, 6, 12 and 24-month followup. Cost data were obtained from a hospital based administrative database and clinical data were obtained via structured medical chart review. Demographics and HRQOL were compared using the t, Fisher exact and chi-square tests. The Wilcoxon and log-T tests were used to compare DMC. Multivariate regression models were used to assess the incremental cost of PCa and predictors of 24-month prostate specific HRQOL. RESULTS: Patients with PCa had a mean annual DMC of 4,160 dollars for the treatment year with a mean length of stay of 3.5 days. They had 3-fold higher DMC than controls. At 12 months, generic HRQOL values were similar to baseline values. Sexual function showed trends toward improvement 6 months after surgery. Urinary function improved significantly by 6 months, although it decreased thereafter. Bowel function and bother returned to baseline values by 3 months. On multivariate regression marital status was a significant predictor of 5 domains of prostate specific HRQOL at 24 months. CONCLUSIONS: Patients with PCa reported weaker sexual function, urinary function and sexual bother at 2 years after treatment compared with their baseline values. There exists an opportunity for improving prostate specific HRQOL in men with early stage PCa.
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