Localized prostate cancer in Norway, the United States, and Spain: Between-country differences of variables before treatment among patients eligible for curative treatment

• Type of Material: Article
• Authors: Anne Holck Storås, The Norwegian Radium Hospital; Martin Sanda, Emory University; Montse Ferrer, Hospital del Mar Research Institute; Jon Håvard Loge, The Norwegian Radium Hospital; Alv A. Dahl, The Norwegian Radium Hospital; Eivind A.S. Steinsvik, Akershus University Hospital; Ferran Guedea, Catalan Institute of Oncology; Milada Cvancarova, The Norwegian Radium Hospital; Sophie D. Fosså, The Norwegian Radium Hospital
• Language: English
• Date: 2014-01-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.clgc.2013.12.007
• Title of Journal or Parent Work: Clinical Genitourinary Cancer
• ISSN: 1558-7673
• Volume: 12
• Issue: 4
• Start Page: e117
• End Page: e125
• Keywords: Norway; Prostatectomy; Urinary Incontinence; Radiotherapy; Surveys and Questionnaires; Male; United States; Radical prostatectomy; Spain; Prostatic Neoplasms; Sexual Dysfunction, Physiological; Neoplasm Staging; Quality of Life; Prostate cancer; Between-country variables; Prognosis; Curative treatment; Aged, 80 and over; Aged; Middle Aged; Adult; Neoplasm Grading; Analysis of Variance; Humans; Follow-Up Studies
• Research Categories: Health Sciences, Oncology; Health Sciences, Epidemiology

Abstract

Background In men with PCa, large variations of PROs after RP or high-dose RAD might be related to between-country differences of medical and sociodemographic variables, and differences in PROs before treatment in the sexual and urinary domains. Patients and Methods In 1908 patients with localized PCa from Norway, the United States, or Spain, the relation between medical (prostate-specific antigen, Gleason score, cT-category) and sociodemographic variables (age, education, marital status) before treatment was investigated. Using the Expanded Prostate Cancer Index Composite questionnaire, PROs before treatment within the sexual and urinary domains were also considered. Results Compared with the European patients, American patients were younger, fewer had comorbid conditions, and more had a high education level. Fifty-three percent of the US men eligible for RP had low-risk tumors compared with 42% and 31% among the Norwegian and the Spanish patients, respectively. Among the Spanish RAD patients, 54% had had low-risk tumors compared with 34% of the American and 21% of the Norwegian men planned for RAD, respectively. Compared with the European patients, significantly fewer US patients reported moderate or severe sexual dysfunction and related problems. In most subgroups, the number of patients with sexual or urinary dysfunction exceeded that of patients with bother related to the reported dysfunction. Conclusion Statistically significant between-country differences were observed in medical and sociodemographic variables, and in PROs before treatment within the sexual and urinary domains. Large differences between reported dysfunction and related problems within the sexual and urinary domains indicate that dysfunction and bother should be reported separately in addition to calculation of summary scores. The documented differences, not at least regarding PROs, might in part explain the large variation of side effects after treatment evident in the medical literature.