Health related quality of life assessment after radical prostatectomy in men with prostate specific antigen only recurrence

Purpose: The health related quality of life assessment is becoming increasi ngly important among patients with prostate cancer. Meanwhile, treatment of patients with increasing prostate specific antigen (PSA) after radical ret ropubic prostatectomy remains controversial. We attempt to define the impac t of PSA recurrence on the health related quality of life of patients after radical retropubic prostatectomy. Materials and Methods: Of 604 consecutive patients who underwent radical re tropubic prostatectomy between March 1991 and September 1998, 510 (84%) wer e available for followup. Each patient was mailed the RAND 36-Item Health S urvey and University of California, Los Angeles, Prostate Cancer Index ques tionnaire. A total of 348 (70%) questionnaires were returned. Health relate d quality of life scores were then compared between patients with and witho ut PSA recurrence. A multivariate analysis was also performed to elucidate further the cause of differences between the groups. Results: Overall, 88 (25%) patients had PSA recurrence. In regard to health related quality of life there were small (less than 10%) but statistically significant differences in 2 of 4 physical health domains (RAND 36-Item He alth Survey). There was a significant decrease in only 1 category of the me ntal health domain for patients with PSA recurrence. Only sexual function w as statistically lower on the University of California, Los Angeles, Prosta te Cancer Index. This result reflects the lower incidence of nerve sparing in these patients, as confirmed by the multivariate analysis. Overall patie nt satisfaction was similar between those with and without PSA recurrence ( 76% and 79%, respectively). Conclusions: Our study demonstrates small health related quality of life di fferences in patients with biochemical PSA recurrence versus those without. These findings provide a baseline assessment of general and disease specif ic health related quality of life domains among these patients. Future stud ies should focus on differences in the measure of cancer anxiety before and after administration of adjuvant therapy in these asymptomatic patients.