Mp58-09 Baseline Health-Related Quality of Life Predicts Metastasis-Free Survival in Men With Intermediate Risk Prostate Cancer Following Radical Prostatectomy

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP58)1 May 2024MP58-09 BASELINE HEALTH-RELATED QUALITY OF LIFE PREDICTS METASTASIS-FREE SURVIVAL IN MEN WITH INTERMEDIATE RISK PROSTATE CANCER FOLLOWING RADICAL PROSTATECTOMY Thilo Westhofen, Alexander Buchner, Lennert Eismann, Severin Rodler, Armin Becker, Christian G. Stief, and Alexander Kretschmer Thilo WesthofenThilo Westhofen , Alexander BuchnerAlexander Buchner , Lennert EismannLennert Eismann , Severin RodlerSeverin Rodler , Armin BeckerArmin Becker , Christian G. StiefChristian G. Stief , and Alexander KretschmerAlexander Kretschmer View All Author Informationhttps://doi.org/10.1097/01.JU.0001008852.83523.41.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intermediate-risk prostate cancer (PC) patients represent a heterogeneous group with highly variable prognoses and treatment recommendations. Previous studies have shown baseline health-related quality of life (HRQOL) to be a robust prognostic indicator for survival outcomes of different cancer entities, with scarce evidence for PC. We therefore sought to examine the prognostic impact of preoperative baseline HRQOL at RP on survival outcomes in men with intermediate risk PC. METHODS: Patients with intermediate-risk PC according to NCCN risk stratification and prospectively assessed preoperative baseline HRQOL prior to RP who underwent RP for PC between 2009 and 2019 were identified within a prospective institutional database. Patients were stratified by the global health status (GHS) domain of the EORTC QLQ-C30 questionnaire. Primary endpoint was metastasis-free survival (MFS). Overall survival (OS) was a key secondary endpoint. Multivariable Cox regression models were applied to assess the prognostic value of baseline GHS on survival outcomes. Harrell's discrimination C-index was applied to calculate the prognostic accuracy of the model. Decision curve analysis was performed to validate the clinical net benefit associated with adding GHS to our multivariable model (p<.05). RESULTS: A total of 4780 patients were included. Median follow-up was 51mo. In multivariable analysis, GHS was confirmed as an independent predictor for increased MFS (HR .98, 95% CI .97-.99; p=.028) and OS (HR .97, 95% CI .95-.99; p=.008), indicating a relative risk reduction of 1.7% for MFS and 2.8% for OS per 1-point increase of baseline GHS. Adding baseline GHS to our multivariable model improved predictive accuracy of prognosis for MFS by 6% (c-index .75 vs .72) and prognosis for OS by 8% (c-index .78 vs .74). Validation with decision curve analysis revealed a net benefit over all threshold probabilities in prediction of MFS and OS when adding GHS to our model. CONCLUSIONS: Our findings highlight that baseline HRQOL is a valuable and robust prognostic factor for patients with intermediate-risk PC prior RP. Baseline HRQOL data improve prognostic accuracy of MFS and OS and could help guiding treatment decision-making. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e950 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Thilo Westhofen More articles by this author Alexander Buchner More articles by this author Lennert Eismann More articles by this author Severin Rodler More articles by this author Armin Becker More articles by this author Christian G. Stief More articles by this author Alexander Kretschmer More articles by this author Expand All Advertisement PDF downloadLoading ...