Background This study describes and compares health-related quality of life
(HRQOL) of prostate cancer patients who received either radical prostatectomy
(nerve-sparing, nsRP, or non-nerve-sparing, nnsRP) or radiotherapy (external
RT, brachytherapy, or both combined) for treatment of localised prostate
cancer. Methods The prospective, multicenter cohort study included 529
patients. Questionnaires included the IIEF, QLQ-C30, and PORPUS-P. Data were
collected before (baseline), three, six, twelve, and twenty-four months after
treatment. Differences between groups’ baseline characteristics were assessed;
changes over time were analysed with generalised estimating equations (GEE).
Missing values were treated with multiple imputation. Further, scores at
baseline and end of follow-up were compared to German reference data. Results
The typical time trend was a decrease of average HRQOL three months after
treatment followed by (partial) recovery. RP patients experienced considerable
impairment in sexual functioning. The covariate-adjusted GEE identified a
significant - but not clinically relevant - treatment effect for diarrhoea (b
= 7.0 for RT, p = 0.006) and PORPUS-P (b = 2.3 for nsRP, b = 2.2 for RT, p =
0.045) compared to the reference nnsRP. Most of the HRQOL scores were
comparable to German norm values. Conclusions Findings from previous research
were reproduced in a specific setting of a patient cohort in the German health
care system. According to the principle of evidence-based medicine, this
strengthens the messages regarding treatment in prostate cancer and its
impacts on patients’ health-related quality of life. After adjustment for
baseline HRQOL and other covariates, RT patients reported increased symptoms
of diarrhoea, and nnsRP patients decreased prostate-specific HRQOL. RP
patients experienced considerable impairment in sexual functioning. These
differences should be taken into account by physicians when choosing the best
therapy for a patient
