Quality of Life in Prostate Cancer Patients Following Radical Prostatectomy: A Systematic Review and Meta-Analysis

Quality of life (QoL) is a key outcome for assessing the effectiveness of treatment and surgical techniques. Radical prostatectomy (RP) impacts QoL in both psychological and physical aspects. This systematic review and meta-analysis aim to evaluate QoL changes in prostate cancer patients before and after RP.

PubMed, EMBASE, and the Cochrane Central Register were searched for studies on PCa patients undergoing RP, with QoL assessed using EORTC QLQ-C30 and/or QLQ-PR25 questionnaires before and one year after surgery. Primary outcomes included overall QoL with open and laparoscopic robotic/hand-assisted RP. Secondary outcomes covered emotional, social, and sexual functioning, urinary symptoms, and pain. Statistical analysis was performed using Review Manager 5.3, following PRISMA guidelines.

A total of 14 studies were incorporated. Overall QoL significantly improved one year after RP (SMD = -0.14; 95%CI [-0,21 - 0,07]; p<0.0001). Laparoscopic/robotic-assisted RP showed statistically significant QoL improvement (SMD = -0.11; 95%CI [-0,15 - 0,07], p<0.0001), while open RP did not (SMD = -0.11; 95%CI[-0,22 - 0,01]; p=0.07). Emotional function improved (SMD = -0.40; 95%CI[-0,49 - 0,31]; p<0.0001), but social function (SMD = 0.07; 95%CI[-0,01 - 0,15]; p=0.09), urinary symptoms (SMD = -0.01; 95%CI[-0,17 - 0,16]; p=0.94), and pain (SMD = 0.01; 95%CI[-0,04 - 0,06]; p=0.70) showed no significant changes. Post-therapy sexual function decreased significantly (SMD = 0.31; 95%CI[0,14 - 0,49]; p=0.0005).

RP is the gold standard for localized PCa, with a significant impact on QoL. The laparoscopic approach offers better QoL outcomes than open RP, though sexual function, urinary symptoms, and social function show limited improvement.