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From bad to worse: comorbidity severity and quality of life after treatment for early-stage prostate cancer

Prostate Cancer and Prostatic Diseases volume 13, pages 320–327 (2010)Cite this article

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Abstract

Commonly used measures of comorbidity assess comorbidity number and type but not severity. We sought to evaluate the impact of comorbidity severity on longitudinal health-related quality of life (HRQOL) in men treated with radical prostatectomy (RP) or radiation therapy (RT) using the Total Illness Burden Index for prostate cancer (TIBI-CaP). We sampled 738 men with non-metastatic prostate cancer treated with RP or RT from the Cancer of the Prostate Strategic Urologic Research Endeavor registry. We examined the impact of comorbidity severity on generic and disease-specific HRQOL at baseline and at 6, 12, 18 and 24 months post-treatment. Men with worse TIBI-CaP comorbidity had significantly lower baseline and post-treatment HRQOL in all domains at all time points. In a multivariate model, men with moderate or severe TIBI-CaP comorbidity had significantly worse HRQOL scores at 12 and 24 months after treatment in all domains except sexual and urinary function (P<0.05); in these domains, severe comorbidity was predictive of lower HRQOL (P<0.05). Comorbidity groups had similar absolute declines in HRQOL from baseline to 6 and 24 months after treatment. Although comorbidity groups experienced similar long-term declines from baseline HRQOL after treatment, men with more severe comorbidity had significantly lower baseline scores and therefore poorer long-term HRQOL.

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Acknowledgements

The Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) is funded in part by an independent educational grant from Abbott Labs.

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Authors and Affiliations

  1. Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    T J Daskivich & M S Litwin

  2. Comprehensive Cancer Centre South (IKZ), Eindhoven Cancer Registry, Eindhoven, The Netherlands

    L V van de Poll-Franse

  3. Jonsson Comprehensive Cancer Center, University of California,

    L Kwan & M S Litwin

  4. Los Angeles, Los Angeles, CA, USA

    L Kwan & M S Litwin

  5. Department of Urology, University of California, San Francisco, San Francisco, CA, USA

    N Sadetsky

  6. Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    D M Stein

  7. Department of Health Services, School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA

    M S Litwin

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  1. T J Daskivich
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  2. L V van de Poll-Franse
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  3. L Kwan
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Correspondence to T J Daskivich.

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Daskivich, T., van de Poll-Franse, L., Kwan, L. et al. From bad to worse: comorbidity severity and quality of life after treatment for early-stage prostate cancer. Prostate Cancer Prostatic Dis 13, 320–327 (2010). https://doi.org/10.1038/pcan.2010.33

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