Impact of age and comorbidities on health-related quality of life for patients with prostate cancer: evaluation before a curative treatment

Abstract

Abstract Background Interpretation of comparative health-related quality of life (HRQOL) studies following different prostate cancer treatments is often difficult due to differing patient ages. Furthermore, age-related changes can hardly be discriminated from therapy-related changes. The evaluation of age-and comorbidity-related changes was in focus of this study. Methods HRQOL of 528 prostate cancer patients was analysed using a validated questionnaire (Expanded Prostate Cancer Index Composite) before a curative treatment. Patients were divided into age groups ≤65, 66–70, 71–75 and >75 years. The impact of specific comorbidities and the Charlson Comorbidity Index (CCI) were evaluated. The questionnaire comprises 50 items concerning the urinary, bowel, sexual and hormonal domains for function and bother. For assessment of sexual and hormonal domains, only patients without prior hormonal treatment were included (n = 336). Results Urinary incontinence was observed increasingly with higher age (mean function scores of 92/88/85/87 for patients ≤65, 66–70, 71–75 and >75 years) – complete urinary control in 78%/72%/64%/58% (p 75 years; p 5 particularly predisposed for lower urinary and sexual HRQOL scores. Conclusion Urinary continence and sexual function are the crucial HRQOL domains with age-related and independently comorbidity-related decreasing scores. The results need to be considered for the interpretation of comparative studies or longitudinal changes after a curative treatment.