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

Area of Science:

• Urology
• Oncology
• Health Outcomes Research

Background:

• Radical prostatectomy (RP) is a primary treatment for localized prostate cancer (PCa).
• RP can significantly affect patients' psychological and physical quality of life (QoL).
• Evaluating QoL changes post-RP is crucial for treatment assessment.

Purpose of the Study:

• To systematically review and meta-analyze QoL changes in PCa patients before and after RP.
• To compare QoL outcomes between open and minimally invasive (laparoscopic/robotic) RP.
• To assess specific QoL domains including emotional, social, sexual functioning, urinary symptoms, and pain.

Main Methods:

• Systematic literature search of PubMed, EMBASE, and Cochrane Central Register.
• Inclusion of 14 studies assessing QoL using EORTC QLQ-C30 and/or QLQ-PR25.
• Meta-analysis of overall QoL, functional domains, and symptom scores one year post-RP.

Main Results:

• Overall QoL significantly improved one year after RP (SMD = -0.14, p<0.0001).
• Laparoscopic/robotic-assisted RP demonstrated significant QoL improvement, unlike open RP.
• Emotional function improved, but social function, urinary symptoms, and pain showed no significant changes; sexual function significantly decreased (SMD = 0.31, p=0.0005).

Conclusions:

• RP significantly impacts QoL in localized PCa patients.
• Minimally invasive laparoscopic approaches yield superior QoL outcomes compared to open RP.
• While overall QoL improves, specific concerns regarding sexual function, urinary symptoms, and social well-being warrant attention.