Der Einfluss von therapiebegleitenden Nebenwirkungen und epidemiologischen Faktoren einschließlich des Versicherungsstatus auf die Lebensqualität von Patienten mit lokal begrenztem Prostatakarzinom 36 Monate nach Beginn der Therapie : eine prospektive Studie

The aim of this survey is to measure the statistic influence of different epidemiological factors including status of health insurance and therapeutic side effects on the Health Related Quality of Life (HRQoL) on patients with localized prostate cancer received either prostatectomy or one form of brachytherapy in the urological clinic of the university clinic of Aachen. Data of patients with a recently diagnosed prostate cancer in the TNM-stadium cT1-cT3 N0 M0 were collected between 1999 and end of 2006. All patients received a self-administered 12-page questionnaire including a HRQoL questionnaire (EORTC QLQ C-30 with the prostate cancer module), questions regarding sexuality and the ICSmale questionnaire for urinary symptoms prior to therapy and 36 months after. Completely filled pre- and post-therapeutic questionnaires of 496 patients could be collected. Patients with a recurrence according to the guidelines of the EAU were excluded from this study. Ultimately a total of 326 data sets were further analyzed. All data are included in a special data base (Aachener Prostatakarzinom Register - APCAR). In a prior study of the same working group the status of health insurance, albeit different between treatment groups could not be defined as an independent variable associated with the treatment method in the urological clinic of the university clinic of Aachen. In addition we find no influence on post therapeutic HRQoL of status of health insurance in this study. In a multivariate analysis we find "sexual functioning" and urgency without leakage as independent significant variables influencing post therapeutic HRQoL. The negative influence of sexual dysfunction on HRQoL is well known and broadly reviewed. Whereas nervesparing techniques have been enhanced urgency without leakage is often clinically neglected and underestimated in literature. Sexual dysfunction and urgency without leakage are therapy associated side effects of the currently available therapy methods and negatively influence post-therapeutic HRQoL. These findings show the importance of a precise informing of patients and their partners of possible therapy associated side effects prior to treatment of localized prostate cancer