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Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance
Abstract 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...
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| Published in: | European urology 2013-07, Vol.64 (1), p.30-36 |
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| creator | Bellardita, Lara Rancati, Tiziana Alvisi, Maria Francesca Villani, Daniela Magnani, Tiziana Marenghi, Cristina Nicolai, Nicola Procopio, Giuseppe Villa, Sergio Salvioni, Roberto Valdagni, Riccardo |
| description | Abstract 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 ( |
| doi_str_mv | 10.1016/j.eururo.2013.01.009 |
| format | article |
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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 (<25th percentile) HRQoL, adjustment to cancer, and a global QoL index at 10 mo after enrolment. Results and limitations The mean age of the study patients was 67 yr (standard deviation: ±7 yr). Lack of partner (odds ratio [OR]: 0.08; p = 0.009) and impaired mental health (OR: 1.2, p = 0.1) were associated with low HRQoL ( p = 0.006; area under the curve [AUC]: 0.72). The maladaptive adjustment to cancer ( p = 0.047; AUC: 0.60) could be predicted by recent diagnosis (OR: 3.3; p = 0.072). Poor global QoL (overall p = 0.02; AUC: 0.85) was predicted by impaired mental health (OR: 1.16; p = 0.070) and time from diagnosis to enrolment in AS <5 mo (OR: 5.52; p = 0.009). Influence of different physicians on the choice of AS (OR: 0.17; p = 0.044), presence of a partner (OR: 0.22; p = 0.065), and diagnostic biopsy with >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.</description><identifier>ISSN: 0302-2838</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2013.01.009</identifier><identifier>PMID: 23357351</identifier><identifier>CODEN: EUURAV</identifier><language>eng</language><publisher>Kidlington: Elsevier B.V</publisher><subject>Active surveillance ; Adaptation, Psychological ; Adjustment to cancer ; Aged ; Biological and medical sciences ; Biopsy ; Coping ; Cost of Illness ; Gynecology. Andrology. Obstetrics ; Humans ; Logistic Models ; Male ; Male genital diseases ; Marital Status ; Medical sciences ; Mental Health ; Middle Aged ; Multivariate Analysis ; Nephrology. Urinary tract diseases ; Odds Ratio ; Prostate cancer ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - psychology ; Prostatic Neoplasms - therapy ; Quality of Life ; Risk Factors ; Social Support ; Stress, Psychological - diagnosis ; Stress, Psychological - etiology ; Stress, Psychological - psychology ; Surveys and Questionnaires ; Time Factors ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland ; Urology ; Watchful Waiting</subject><ispartof>European urology, 2013-07, Vol.64 (1), p.30-36</ispartof><rights>European Association of Urology</rights><rights>2013 European Association of Urology</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-6e209182daa380cea406bbd9a4e9ed3b9f279ecb6c386f9ce9a696f238c308493</citedby><cites>FETCH-LOGICAL-c447t-6e209182daa380cea406bbd9a4e9ed3b9f279ecb6c386f9ce9a696f238c308493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27453404$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23357351$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bellardita, Lara</creatorcontrib><creatorcontrib>Rancati, Tiziana</creatorcontrib><creatorcontrib>Alvisi, Maria Francesca</creatorcontrib><creatorcontrib>Villani, Daniela</creatorcontrib><creatorcontrib>Magnani, Tiziana</creatorcontrib><creatorcontrib>Marenghi, Cristina</creatorcontrib><creatorcontrib>Nicolai, Nicola</creatorcontrib><creatorcontrib>Procopio, Giuseppe</creatorcontrib><creatorcontrib>Villa, Sergio</creatorcontrib><creatorcontrib>Salvioni, Roberto</creatorcontrib><creatorcontrib>Valdagni, Riccardo</creatorcontrib><title>Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance</title><title>European urology</title><addtitle>Eur Urol</addtitle><description>Abstract 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 (<25th percentile) HRQoL, adjustment to cancer, and a global QoL index at 10 mo after enrolment. Results and limitations The mean age of the study patients was 67 yr (standard deviation: ±7 yr). Lack of partner (odds ratio [OR]: 0.08; p = 0.009) and impaired mental health (OR: 1.2, p = 0.1) were associated with low HRQoL ( p = 0.006; area under the curve [AUC]: 0.72). The maladaptive adjustment to cancer ( p = 0.047; AUC: 0.60) could be predicted by recent diagnosis (OR: 3.3; p = 0.072). Poor global QoL (overall p = 0.02; AUC: 0.85) was predicted by impaired mental health (OR: 1.16; p = 0.070) and time from diagnosis to enrolment in AS <5 mo (OR: 5.52; p = 0.009). Influence of different physicians on the choice of AS (OR: 0.17; p = 0.044), presence of a partner (OR: 0.22; p = 0.065), and diagnostic biopsy with >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.</description><subject>Active surveillance</subject><subject>Adaptation, Psychological</subject><subject>Adjustment to cancer</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Coping</subject><subject>Cost of Illness</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Marital Status</subject><subject>Medical sciences</subject><subject>Mental Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Odds Ratio</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - psychology</subject><subject>Prostatic Neoplasms - therapy</subject><subject>Quality of Life</subject><subject>Risk Factors</subject><subject>Social Support</subject><subject>Stress, Psychological - diagnosis</subject><subject>Stress, Psychological - etiology</subject><subject>Stress, Psychological - psychology</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><subject>Urology</subject><subject>Watchful Waiting</subject><issn>0302-2838</issn><issn>1873-7560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqFkkuLFDEQgIMo7uzoPxDJRfDSbSXpVy7CMLquMODK6jmkk2rN2NO95jEw_940Myp48VSH-ur1UYS8YFAyYM2bfYnJJz-XHJgogZUA8hFZsa4VRVs38JisQAAveCe6K3Idwh4ARC3FU3LFhahbUbMVcXcerTNx9oHOA71FPcbvhcdRR7T0c9Kji6cls3MDUj1ZurH7FOIBp0jjTO_8HGJm6VZPBj19l7ybvtGNie6I9D75I7pxXHLPyJNBjwGfX-KafL15_2V7W-w-ffi43ewKU1VtLBrkIFnHrdaiA4O6gqbvrdQVSrSilwNvJZq-MaJrBmlQ6kY2AxedEdBVUqzJ63PfBz__TBiiOrhgcFkC5xQUE01Tt22Xra1JdUZNviJ4HNSDdwftT4qBWiSrvTpLVotkBUxlybns5WVC6g9o_xT9tpqBVxdAB6PHwef7XfjLtVUtKqgy9_bMYfZxdOhVMA6zK-s8mqjs7P63yb8NzOgml2f-wBOG_Zz8lF0rpgJXoO6Xh1j-gYn8C4xz8QuIM7Is</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Bellardita, Lara</creator><creator>Rancati, Tiziana</creator><creator>Alvisi, Maria Francesca</creator><creator>Villani, Daniela</creator><creator>Magnani, Tiziana</creator><creator>Marenghi, Cristina</creator><creator>Nicolai, Nicola</creator><creator>Procopio, Giuseppe</creator><creator>Villa, Sergio</creator><creator>Salvioni, Roberto</creator><creator>Valdagni, Riccardo</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance</title><author>Bellardita, Lara ; Rancati, Tiziana ; Alvisi, Maria Francesca ; Villani, Daniela ; Magnani, Tiziana ; Marenghi, Cristina ; Nicolai, Nicola ; Procopio, Giuseppe ; Villa, Sergio ; Salvioni, Roberto ; Valdagni, Riccardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-6e209182daa380cea406bbd9a4e9ed3b9f279ecb6c386f9ce9a696f238c308493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Active surveillance</topic><topic>Adaptation, Psychological</topic><topic>Adjustment to cancer</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Coping</topic><topic>Cost of Illness</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Marital Status</topic><topic>Medical sciences</topic><topic>Mental Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Odds Ratio</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - psychology</topic><topic>Prostatic Neoplasms - therapy</topic><topic>Quality of Life</topic><topic>Risk Factors</topic><topic>Social Support</topic><topic>Stress, Psychological - diagnosis</topic><topic>Stress, Psychological - etiology</topic><topic>Stress, Psychological - psychology</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><topic>Urology</topic><topic>Watchful Waiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bellardita, Lara</creatorcontrib><creatorcontrib>Rancati, Tiziana</creatorcontrib><creatorcontrib>Alvisi, Maria Francesca</creatorcontrib><creatorcontrib>Villani, Daniela</creatorcontrib><creatorcontrib>Magnani, Tiziana</creatorcontrib><creatorcontrib>Marenghi, Cristina</creatorcontrib><creatorcontrib>Nicolai, Nicola</creatorcontrib><creatorcontrib>Procopio, Giuseppe</creatorcontrib><creatorcontrib>Villa, Sergio</creatorcontrib><creatorcontrib>Salvioni, Roberto</creatorcontrib><creatorcontrib>Valdagni, Riccardo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bellardita, Lara</au><au>Rancati, Tiziana</au><au>Alvisi, Maria Francesca</au><au>Villani, Daniela</au><au>Magnani, Tiziana</au><au>Marenghi, Cristina</au><au>Nicolai, Nicola</au><au>Procopio, Giuseppe</au><au>Villa, Sergio</au><au>Salvioni, Roberto</au><au>Valdagni, Riccardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance</atitle><jtitle>European urology</jtitle><addtitle>Eur Urol</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>64</volume><issue>1</issue><spage>30</spage><epage>36</epage><pages>30-36</pages><issn>0302-2838</issn><eissn>1873-7560</eissn><coden>EUURAV</coden><abstract>Abstract 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 (<25th percentile) HRQoL, adjustment to cancer, and a global QoL index at 10 mo after enrolment. Results and limitations The mean age of the study patients was 67 yr (standard deviation: ±7 yr). Lack of partner (odds ratio [OR]: 0.08; p = 0.009) and impaired mental health (OR: 1.2, p = 0.1) were associated with low HRQoL ( p = 0.006; area under the curve [AUC]: 0.72). The maladaptive adjustment to cancer ( p = 0.047; AUC: 0.60) could be predicted by recent diagnosis (OR: 3.3; p = 0.072). Poor global QoL (overall p = 0.02; AUC: 0.85) was predicted by impaired mental health (OR: 1.16; p = 0.070) and time from diagnosis to enrolment in AS <5 mo (OR: 5.52; p = 0.009). Influence of different physicians on the choice of AS (OR: 0.17; p = 0.044), presence of a partner (OR: 0.22; p = 0.065), and diagnostic biopsy with >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.</abstract><cop>Kidlington</cop><pub>Elsevier B.V</pub><pmid>23357351</pmid><doi>10.1016/j.eururo.2013.01.009</doi><tpages>7</tpages></addata></record> |
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| subjects | Active surveillance Adaptation, Psychological Adjustment to cancer Aged Biological and medical sciences Biopsy Coping Cost of Illness Gynecology. Andrology. Obstetrics Humans Logistic Models Male Male genital diseases Marital Status Medical sciences Mental Health Middle Aged Multivariate Analysis Nephrology. Urinary tract diseases Odds Ratio Prostate cancer Prostatic Neoplasms - pathology Prostatic Neoplasms - psychology Prostatic Neoplasms - therapy Quality of Life Risk Factors Social Support Stress, Psychological - diagnosis Stress, Psychological - etiology Stress, Psychological - psychology Surveys and Questionnaires Time Factors Tumors Tumors of the urinary system Urinary tract. Prostate gland Urology Watchful Waiting |
| title | Predictors of Health-related Quality of Life and Adjustment to Prostate Cancer During Active Surveillance |
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