Background: To explore cross‐sectional and longitudinal differences in general
health‐related and prostate cancer‐specific quality of life (QoL) after robotic‐assisted (RARP) and laparoscopic (LRP) radical prostatectomy and to analyze predictive variables for QoL outcomes.
Methods: In this multicenter, randomized controlled trial, prostate cancer patients
were randomly assigned 3:1 to undergo either RARP or LRP. Patient‐reported outcomes were prospectively collected before and 1, 3, 6, 12 months after radical
prostatectomy and included QoL as a secondary outcome. Validated questionnaires
were used to assess general health‐related (EORTC QLQ‐C30) and prostate cancerspecific (QLQ‐PR25) QoL. Cross‐sectional and longitudinal contrasts were analyzed through linear mixed models. Predictive variables for QoL outcomes were identified by general linear modeling.
Results: Of 782 randomized patients, QoL was evaluable in 681 patients. In terms of
general QoL, the cross‐sectional analysis showed only small differences between
study arms, whereas longitudinal comparison indicated an advantage of RARP on
recovery: RARP patients reported an earlier return to baseline in global health status (3 vs. 6 months) and social functioning (6 vs. 12 months). In role functioning, only the RARP arm regained baseline scores. Regarding prostate‐specific QoL, LRP patients experienced more urinary symptoms and reported 3.2 points (95% confidence interval 0.4–6, p = 0.024) higher mean scores at 1‐month follow‐up and in mean 2.9 points (0.1–5, p = 0.042) higher urinary symptoms scores at 3‐month follow‐up than RARP patients. There were no other significant differences between treatment groups. Urinary symptoms, sexual activity, and sexual function remained significantly worse compared with baseline at all time points in both arms.
Conclusions: Compared with LRP, the robotic approach led to an earlier return to
baseline in several domains of general health‐related QoL and better short‐term
recovery of urinary symptoms. Predictive variables such as the scale‐specific baseline status and bilateral nerve‐sparing were confirmed.:1 Abkürzungsverzeichnis 3
2 Einführung 4
2.1 Das Prostatakarzinom 4
2.1.1 Vorsorge und Diagnostik 4
2.1.2 Grundsätze der Therapie 5
2.1.3 Die radikale Prostatektomie 6
2.2 Lebensqualität 8
2.2.1 Gesundheitsbezogene Lebensqualität 8
2.2.2 Lebensqualität von Prostatakarzinompatienten 9
2.2.3 Prädiktoren der Lebensqualität nach radikaler Prostatektomie 12
2.3 Die LAP-01 Studie 13
2.3.1 Studiendesign 13
2.3.2 Lebensqualität im Rahmen der LAP-01 Studie 15
2.4 Zielsetzung und Fragestellung 16
3 Publikationsmanuskript 17
4 Zusammenfassung der Arbeit 28
5 Literaturverzeichnis 33
6 Anlagen 39
6.1 EORTC QLQ-C30 39
6.2 EORTC QLQ-PR25 42
7 Darstellung des eigenen Beitrags 44
8 Selbstständigkeitserklärung 45
9 Lebenslauf 46
10 Danksagung 48
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:83391 |
| Date | 06 February 2023 |
| Creators | Lemaire, Emilie |
| Contributors | Thomas, Christian, Dietz, Andreas, Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | German |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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