The impact of psychiatric pathology on the prognosis and survival of men with prostate cancer undergoing radical prostatectomy

• Published in: Actas urológicas españolas (English ed.) 2022-12, Vol.46 (10), p.646-652
• Main Authors: Cózar-Ortiz, J.D., Cózar-Olmo, J.M., Álvarez-Ossorio-Fernández, J.L., Esteban-Fuertes, M., Chantada-Abal, V., Valverde-Martínez, L.S., Márquez-Sánchez, M.T., Padilla-Fernández, B.Y., Lorenzo-Gómez, M.F.
• Format: Article
• Language: English
• Subjects: Cáncer de próstata; Mental health; Prognosis; Pronóstico; Prostate cancer; Prostatectomía radical; Radical prostatectomy; Salud mental; Supervivencia; Survival
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/j.acuroe.2022.10.003

Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with prostate cancer undergoing RP and identified the effects of psychiatric diagnoses on their survival and prognosis. Retrospective multicenter observational study including 1078 men treated with RP for organ-confined prostate cancer. Groups: GP: patients with psychiatric pathology prior to RP; GNP: patients without psychiatric pathology prior to RP. Urological, oncological and psychiatric variables, descriptive statistics and multivariate analysis were included. 37.94% of patients presented a psychiatric diagnosis. Adjuvant radiotherapy was required in 27.83% and hormone therapy in 23.38%; being more frequent in GP. Cancer-specific survival was higher in GNP. Anxiety, depression, insomnia, smoking, psychosis and alcoholism were the most frequent. Low TNM and low presence of LUTS and SUI increased the probability of absence of psychiatric pathology. Fatigue, erectile dysfunction and cognitive impairment after RP with RT and/or HT were higher in GP. Older age and higher PSA at diagnosis increased the relative risk of psychiatric pathology and worse outcome. The most frequently related factors were RP, PSA, age and survival time. Psychiatric pathology is present in patients undergoing radical prostatectomy for prostate cancer, with a high impact on survival and prognostic outcomes. La ansiedad específica del cáncer es la reacción psicológica más frecuentemente tras la prostatectomía radical (PR). Evaluamos la prevalencia de la patología psiquiátrica pretratamiento de cáncer de próstata mediante PR e identificamos la influencia de los diagnósticos psiquiátricos en la supervivencia y pronóstico en los pacientes. Estudio retrospectivo multicéntrico observacional, 1.078 varones intervenidos mediante PR por cáncer de próstata órgano-confinado. Grupos: GP: pacientes con patología psiquiátrica previa a la PR; GNP: pacientes sin patología psiquiátrica previa a la PR, variables urológicas, oncológicas y psiquiátricas, estadística descriptiva y análisis multivariante. El 37,94% presentó algún diagnóstico psiquiátrico. Fue necesario tratamiento adyuvante de radioterapia en 27,83% y hormonoterapia en 23,38%; más frecuentes en GP. La supervivencia cáncer-específica fue superior en GNP. La ansiedad, depresión, insomnio, tabaquismo, psicosis y alcoholismo fueron los más frecuentes. E