TRANSITIONS IN HEALTH-RELATED QUALITY-OF-LIFE DURING THE FIRST 9 MONTHS AFTER DIAGNOSIS WITH PROSTATE-CANCER

Health-Related Quality of Life (HRQOL) is an important outcome measure in the study of prostate cancer. There are few data regarding the eff ect of sociodemographic variables, such as insurance status, education al level, marital status or income, on HRQOL. We examined whether thes e or other sociodemographic and clinical variables are predictive of H RQOL outcomes using an observational database of prostate cancer patie nts accrued from a wide array of clinical practice settings. We studie d 131 patients with newly-diagnosed prostate cancer who had been follo wed for at least nine months. Patients were enrolled in CaPSURE(TM), a large, observational database of patients with prostate cancer. Gener al and disease-specific HRQOL were measured with established, validate d instruments at diagnosis and nine months later. Sociodemographic dat a and co-morbidity counts were recorded at baseline. Multivariate regr ession analysis was used to determine whether sociodemographic or clin ical variables were predictive of baseline HRQOL or HRQOL changes duri ng the study period. Several sociodemographic and clinical variables d emonstrated significant associations with HRQOL. We found improvements in general and disease-specific domains of HRQOL during the nine mont hs after diagnosis. For married patients, Emotional Well-Being and Fam ily Functioning scores were better at baseline (+11.8, P < 0.02), but Family Functioning declined over the nine month study period (-18.5, P = 0.0006). Older patients had slightly better baseline performance in several domains of HRQOL, but experienced greater HRQOL decrements ov er time than did younger patients. Increasing comorbidity was associat ed with worse baseline general HRQOL. Early tumor stage was predictive of better scores in general HRQOL domains at baseline. Limited palpab le disease stage (T2A/T2B) was predictive of worse Sexual Function and Sexual Bother at nine months (-8.6, P = 0.04; -24, P = 0.008). After initial decreases, patients appear to experience an improvement in gen eral and disease-specific HRQOL within nine months of initial diagnosi s with prostate cancer. Marital status is associated with better HRQOL , while advancing age is associated with more significant HRQOL declin es over time. Patients with lower stage disease were noted to have bet ter general HRQOL at baseline, although decreases in the physical doma ins were noted at nine months. These data shed new light on patients' experience with prostate cancer and suggest that HRQOL outcomes over t ime may occur in a predictable manner.