The effect of the discrepancy between pre- and post-operative staging on decision-making and quality of life in men undergoing a radical prostatectomy

Abstract

Prostate cancer is the most prevalent cancer and the second leading cause of oncological mortality in men. Its prognosis is estimated by normograms based on statistical methods. However, it is still a challenge to accurately determine the pathological stage from clinical data. Our aim is to describe and analyze the relationship between sociodemographic, quality-of-life and clinical variables in patients undergoing a radical prostatectomy. A cross-sectional observational study was carried out and included 51 patients undergoing a radical prostatectomy in a general hospital in southeastern Spain. The normality of all variables was studied. A descriptive and association/correlation analysis of the most relevant variables of the study was carried out. In addition, a multivariate analysis was performed to study the intergroup differences between variables with significant correlation. Age was related to a higher occurrence of erectile dysfunction (f = 10.594, p = 0.09) and to a lower percentage of consultations for this reason (x2 = 6.996, p = 0.012). Overweight/obese patients had a more aggressive result on the Gleason score (w = 151.5, p = 0.019). Differences were found between ultrasound and surgical specimen prostate volume (f = 10.324, p = 0.004). There were differences between the Gleason score result obtained from the biopsy and the surgical specimen (f = 23.330, p = 0.00001). Our results suggest that older age could be related to increased erectile dysfunction, that obesity could be related to more aggressive prostate cancer, and that there can be differences in the Gleason score between the biopsy and the final specimen. These findings suggest that the Gleason score results should be interpreted cautiously.

Keywords

• prostate cancer
• prostatectomy
• staging
• gleason score