Recovery of health related quality of life in the year after radical prostatectomy: Early experience

Purpose: We determined the temporal course of patient return to baseline qu ality of life after treatment with radical prostatectomy for early stage pr ostate cancer. Materials and Methods: After establishing a longitudinal observational data base of men undergoing radical retropubic prostatectomy we used established , validated quality of life questionnaires (RAND 36-Item Health Survey and University of California, Los Angeles Prostate Cancer Index) to document ch anges in general and disease specific health related quality of life (HRQOL ). We assessed 90 patients at baseline before surgery and then at 3-month i ntervals for 1 year postoperatively. Logistic regression was used to explor e predictors of the return to baseline. Results: After prostatectomy patients had a significant decrease in all dom ains of HRQOL. Return to baseline was rapid in the general and bowel domain s with at least two-thirds to three-fourths of patients reaching pretreatme nt levels within 6 months of surgery. Return to baseline was slower in the urinary and sexual function domains with 61 and 31% of the men, respectivel y, reaching pretreatment levels by 1 year after surgery. Of those who reach ed baseline the average intervals for the bowel, sexual and urinary domains were 5, 6 and 7 months, respectively. Married and white patients were more likely to achieve a return to baseline HRQOL during year 1 postoperatively . However, education level was inversely associated with the likelihood of returning to baseline. Conclusions: During the year after radical prostatectomy for early stage pr ostate cancer patient quality of life steadily improved. By 3 months postop eratively 30 to 40% of the patients had already recovered baseline levels o f physical, mental and social functioning, and by 6 months more than 70% ha d reached baseline in the general HRQOL domains. By :12 months after surger y 86 to 97% of the patients had returned to baseline levels in each domain. Each domain continued to improve throughout the year. For the patients who reached baseline general HRQOL during followup average recovery time was 5 to 6 months.