Research and Reports in Urology (Feb 2022)

Impacts of Neoadjuvant Hormonal Therapy Prior to Robot-Assisted Radical Prostatectomy on Postoperative Hormonal- and Sexual-Related Quality of Life – Assessment by Patient-Reported Questionnaire

  • Ogawa S,
  • Hasegawa A,
  • Makabe S,
  • Onagi A,
  • Matsuoka K,
  • Kayama E,
  • Koguchi T,
  • Hata J,
  • Sato Y,
  • Akaihata H,
  • Kataoka M,
  • Haga N,
  • Kojima Y

Journal volume & issue
Vol. Volume 14
pp. 39 – 48

Abstract

Read online

Soichiro Ogawa,1 Akihisa Hasegawa,1 Shunta Makabe,1 Akifumi Onagi,1 Kanako Matsuoka,1 Emina Kayama,1 Tomoyuki Koguchi,1 Junya Hata,1 Yuichi Sato,1 Hidenori Akaihata,1 Masao Kataoka,1 Nobuhiro Haga,2 Yoshiyuki Kojima1 1Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan; 2Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, JapanCorrespondence: Soichiro Ogawa, Department of Urology, Fukushima Medical University School of Medicine, 1, Hikarigaoka, Fukushima, 960-1295, Japan, Tel +81 24 547 1316, Fax +81 24 548 3393, Email [email protected]: Neoadjuvant hormonal therapy (HT) before radical prostatectomy (RP) is not recommended by current guidelines in terms of oncological outcomes. Despite this, neoadjuvant HT is sometimes conducted before RP for a small proportion of patients in clinical practice. This study evaluated the impacts of neoadjuvant HT on hormonal- and sexual-related quality of life (QOL) among patients who underwent robot-assisted RP (RARP).Materials and Methods: Participants comprised 470 patients divided into a non-neoadjuvant HT group (n = 408) and a neoadjuvant HT group (n = 62). Hormonal- and sexual-related QOL were measured using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire.Results: Hormonal summary scores at 6 and 9 months, function scores before and 3, 6, and 9 months and bother score at 6 months after RARP were significantly lower in the neoadjuvant HT group than in the non-neoadjuvant HT group. Sexual function scores were decreased in the neoadjuvant HT group compared to the non-neoadjuvant HT group before and 6 months after RARP. In the neoadjuvant HT group, sexual function at 3 months after RARP was significantly worse in patients with > 5 months of neoadjuvant HT than in patients with ≤ 5 months of neoadjuvant HT. Conversely, sexual bother at 3 months after RARP was significantly worse in patients with ≤ 5 months of neoadjuvant HT than in patients with > 5 months of neoadjuvant HT.Conclusion: Vintage neoadjuvant HT prior to RARP should not be recommended due to not only oncological outcomes, but also the impacts on postoperative hormonal- and sexual-related QOL.Keywords: androgen deprivation therapy, Expanded Prostate Cancer Index Composite, quality of life, hormonal therapy, neoadjuvant, robot-assisted radical prostatectomy

Keywords