Objective: To prospectively evaluate the acute and short-term effects of radical retropubic prostatectomy (RRP) on health-related quality of life (HRQoL) using a validated generic HRQoL instrument that measures overall health status, as although there is increasing interest in the HRQoL of patients being treated for prostate cancer, most studies have focused on long-term outcomes.
Patients and methods: In all, 121 men undergoing RRP for clinically localized prostate cancer were prospectively evaluated for short-term HRQoL using an acute Short Form-12 version-2 Physical and Mental Health Survey Acute Form before and serially each week from 1 to 6 weeks after RRP. The physical (PCS) and mental component score (MCS) were calculated from the questionnaires at each time and the data analysed by random coefficient modelling. Separate models were fitted for MCS and PCS using covariates of race, age, estimated blood loss (EBL), time after RRP, and their interaction terms.
Results: The PCS initially declined and improved linearly. and the baseline level was not achieved by 6 weeks, but modelling lines showed an expected return to baseline at 7-8 weeks for all patients. Age had a significant relationship with the PCS; older men (>60 years) scored higher, and their PCS remained significantly higher after RRP than younger men (< or =60 years) until 5 weeks. EBL also had a significant relationship with PCS; men with an EBL of >500 mL had a significantly lower PCS at 1 week and this remained significantly lower than for men with an EBL of < or = 500 mL until approximately 7 weeks. The MCS improved immediately after RRP and remained higher throughout the study than at baseline. Race was the only covariate for which there were significant differences in the MCS. The MCS was significantly lower at baseline for African-Americans than for Caucasian Americans, and remained lower until 6 weeks after RRP.
Conclusions: There were significant changes in HRQoL during in the short-term after RRP. Younger men and those with a higher EBL might have a slower recovery of the PCS after RRP. African-Americans had a slower increase in MCS and might have a different initial emotional or mental health response to RRP than have Caucasians.