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Prospective, Longitudinal, Comparative Study Of Health-Related Quality Of Life (QOL) In Patients Undergoing Primary Cryoablation Of the Prostate and Brachytherapy: A Comparative Study Of Two Minimally Invasive Ablative Techniques
Scott G Hubosky*1, Christopher M. Tepera1, Michael D. Fabrizio1, Paul F. Schellhammer1, Bethany B. Gambill*2, Robert W. Given1
1Eastern Virginia Medical School, Norfolk, VA;2Urology of Virginia, Norfolk, VA
Introduction: Only three published reports exist on QOL parameters for prostate cryoablation and none include third generation techniques. We review disease-specific QOL parameters in a consecutive series of patients undergoing primary cryoablation (cryo) using third generation techniques and compare these to a contemporary series of 103Pd brachytherapy ( 103Pd) patients.
Methods: A prospective, longitudinal study was performed on 89 patients undergoing cryoablation and 123 patients undergoing brachytherapy using the UCLA Prostate Cancer Index (PCI) and AUA symptom scores. Questionnaires were administered before treatment and at 1,3,6,9,12,18, and 24 months after treatment. We compared percent of baseline score (%BS) for disease specific domains over different post-treatment intervals.
Results: Response rates were 71% for cryo and 51% for 103 Pd. At baseline, cryo patients were older (p<0.001) and had lower baseline scores for sexual function (SF)(p=0.04) and urinary function(UF)(p=0.03). At 12 months, cryo patients achieved baseline scores in urinary and bowel domains. Less irritative/obstructive symptoms as noted by AUA SS were observed in cryo vs. 103Pd at 1 month (p=0.07) and 3 months (p=0.003). UF was equivalent initially but was better in cryo at 18 months (p=0.01) and 24 months (p=0.04). At 12 months, 103Pd had higher %BS in SF compared to cryo (p=0.02).
Conclusions: Compared to 103Pd, cryotherapy demonstrates less irritative/obstructive symptoms in the early post-treatment period and improves UF up to 24 months after treatment. 103Pd patients experienced less depression in SF up to 12 months compared to an older population of cryo patients with more baseline erectile dysfunction.
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