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Abstract：
Nerve-sparing (NS) surgery was developed to improve postoperative sexual and potentially urological outcomes after radical prostatectomy (RP). However, it is largely unknown how NSRP affects health-related quality of life (HRQoL) including urinary and sexual outcomes in prostate cancer (PC) survivors 5-10 years after diagnosis in comparison with Non-NSRP.
The study population included 382 stage pT2-T3N0M0 PC survivors 5-10 years post diagnosis, who were identified from the multiregional Prostate Cancer Survivorship in Switzerland (PROCAS) study. Briefly, in 2017/2018, PC survivors were identified via six population-based cancer registries based in both German- and French-speaking Switzerland. HRQoL and PC-specific symptom burden was assessed using the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires. Differences in HRQoL outcomes between survivors treated with NSRP (uni- & bilateral) and Non-NSRP were analyzed with multivariable linear regression adjusted for age, years since diagnosis, cancer stage, comorbidities at diagnosis, and further therapies, if appropriate. Multiple imputation was performed to minimize the bias due to missing data.
Five to ten years after diagnosis, PC survivors treated with NSRP and Non-NSRP reported similar symptom burden and comparable HRQoL function scores. The only significant differences were reported for sexual activity, whereas PC survivors who underwent NSRP reported statistically significant (P = .031) higher sexual activity than those on Non-NSRP. NSRP and Non-NSRP reported similar scores for urinary symptoms and all other HRQoL outcomes.
Our results support nerve-sparing techniques as an option to improve postoperative sexual, but not urinary outcomes after RP in long-term PC survivors.
The study population included 382 stage pT2-T3N0M0 PC survivors 5-10 years post diagnosis, who were identified from the multiregional Prostate Cancer Survivorship in Switzerland (PROCAS) study. Briefly, in 2017/2018, PC survivors were identified via six population-based cancer registries based in both German- and French-speaking Switzerland. HRQoL and PC-specific symptom burden was assessed using the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires. Differences in HRQoL outcomes between survivors treated with NSRP (uni- & bilateral) and Non-NSRP were analyzed with multivariable linear regression adjusted for age, years since diagnosis, cancer stage, comorbidities at diagnosis, and further therapies, if appropriate. Multiple imputation was performed to minimize the bias due to missing data.
Five to ten years after diagnosis, PC survivors treated with NSRP and Non-NSRP reported similar symptom burden and comparable HRQoL function scores. The only significant differences were reported for sexual activity, whereas PC survivors who underwent NSRP reported statistically significant (P = .031) higher sexual activity than those on Non-NSRP. NSRP and Non-NSRP reported similar scores for urinary symptoms and all other HRQoL outcomes.
Our results support nerve-sparing techniques as an option to improve postoperative sexual, but not urinary outcomes after RP in long-term PC survivors.
摘要：
开发保留神经（NS）手术以改善根治性前列腺切除术（RP）后的术后性和潜在泌尿外科结局。然而,与Non-NSRP相比,NSRP如何影响前列腺癌(PC)幸存者诊断后5-10年的健康相关生活质量(HRQoL),包括泌尿和性结局,目前尚不清楚.
研究人群包括382期pT2-T3N0M0PC幸存者，诊断后5-10年，从瑞士多区域前列腺癌幸存者（PROCAS）研究中确定。简而言之，在2017/2018年,通过位于德语和法语瑞士的6个基于人群的癌症登记处确定了PC幸存者.使用EORTCQLQ-C30和EORTCQLQ-PR25问卷评估HRQoL和PC特异性症状负担。使用多变量线性回归分析接受NSRP（单和双侧）和非NSRP治疗的幸存者之间的HRQoL结果差异，诊断多年来，癌症阶段，诊断时的合并症，和进一步的治疗，如果合适。进行了多次填补，以最大程度地减少由于数据缺失导致的偏差。
诊断后五到十年，接受NSRP和非NSRP治疗的PC幸存者报告了相似的症状负担和可比的HRQoL功能评分。据报道，性活动的唯一显着差异，而接受NSRP的PC幸存者报告的性活动比非NSRP高（P=0.031）。NSRP和Non-NSRP报告的泌尿症状和所有其他HRQoL结果得分相似。
我们的结果支持保留神经技术作为改善术后性生活的一种选择，但不是长期PC幸存者RP后的尿路结局。
研究人群包括382期pT2-T3N0M0PC幸存者，诊断后5-10年，从瑞士多区域前列腺癌幸存者（PROCAS）研究中确定。简而言之，在2017/2018年,通过位于德语和法语瑞士的6个基于人群的癌症登记处确定了PC幸存者.使用EORTCQLQ-C30和EORTCQLQ-PR25问卷评估HRQoL和PC特异性症状负担。使用多变量线性回归分析接受NSRP（单和双侧）和非NSRP治疗的幸存者之间的HRQoL结果差异，诊断多年来，癌症阶段，诊断时的合并症，和进一步的治疗，如果合适。进行了多次填补，以最大程度地减少由于数据缺失导致的偏差。
诊断后五到十年，接受NSRP和非NSRP治疗的PC幸存者报告了相似的症状负担和可比的HRQoL功能评分。据报道，性活动的唯一显着差异，而接受NSRP的PC幸存者报告的性活动比非NSRP高（P=0.031）。NSRP和Non-NSRP报告的泌尿症状和所有其他HRQoL结果得分相似。
我们的结果支持保留神经技术作为改善术后性生活的一种选择，但不是长期PC幸存者RP后的尿路结局。
