Quality of life and satisfaction with outcome among prostate-cancer survivors.
20 Mar 2008-The New England Journal of Medicine (Massachussetts Medical Society)-Vol. 358, Iss: 12, pp 1250-1261
TL;DR: Each prostate-cancer treatment was associated with a distinct pattern of change in quality-of-life domains related to urinary, sexual, bowel, and hormonal function, and these changes influenced satisfaction with treatment outcomes among patients and their spouses or partners.
Abstract: Background We sought to identify determinants of health-related quality of life after primary treatment of prostate cancer and to measure the effects of such determinants on satisfaction with the outcome of treatment in patients and their spouses or partners. Methods We prospectively measured outcomes reported by 1201 patients and 625 spouses or partners at multiple centers before and after radical prostatectomy, brachytherapy, or external-beam radiotherapy. We evaluated factors that were associated with changes in quality of life within study groups and determined the effects on satisfaction with the treatment outcome. Results Adjuvant hormone therapy was associated with worse outcomes across multiple quality-of-life domains among patients receiving brachytherapy or radiotherapy. Patients in the brachytherapy group reported having long-lasting urinary irritation, bowel and sexual symptoms, and transient problems with vitality or hormonal function. Adverse effects of prostatectomy on sexual function were ...
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University of Minnesota1, Harvard University2, Veterans Health Administration3, Agency for Healthcare Research and Quality4, University of Pittsburgh5, University of Michigan6, United States Department of Veterans Affairs7, University of Texas at Dallas8, Washington University in St. Louis9, University of Oklahoma10, Baylor College of Medicine11
TL;DR: Among men with localized prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up.
Abstract: During the median follow-up of 10.0 years, 171 of 364 men (47.0%) assigned to radi cal prostatectomy died, as compared with 183 of 367 (49.9%) assigned to observation (hazard ratio, 0.88; 95% confidence interval [CI], 0.71 to 1.08; P = 0.22; absolute risk reduction, 2.9 percentage points). Among men assigned to radical prostatectomy, 21 (5.8%) died from prostate cancer or treatment, as compared with 31 men (8.4%) assigned to observation (hazard ratio, 0.63; 95% CI, 0.36 to 1.09; P = 0.09; absolute risk reduction, 2.6 percentage points). The effect of treatment on all-cause and prostate-cancer mortality did not differ according to age, race, coexisting conditions, self-reported performance status, or histologic features of the tumor. Radical prostatectomy was associated with reduced all-cause mortality among men with a PSA value greater than 10 ng per milliliter (P = 0.04 for interaction) and possibly among those with intermediate-risk or high-risk tumors (P = 0.07 for interaction). Adverse events within 30 days after surgery occurred in 21.4% of men, including one death. CONCLUSIONS Among men with localized prostate cancer detected during the early era of PSA test ing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up. Absolute differences were less than 3 percentage points. (Funded by the Department of Veterans Affairs Cooperative Studies Program and others; PIVOT ClinicalTrials .gov number, NCT00007644.)
1,590 citations
University of Alabama at Birmingham1, University of South Florida2, Vanderbilt University3, City of Hope National Medical Center4, Fox Chase Cancer Center5, University Of Tennessee System6, Brigham and Women's Hospital7, Seattle Cancer Care Alliance8, Case Western Reserve University9, Roswell Park Cancer Institute10, Northwestern University11, Harvard University12, University of Nebraska Medical Center13, University of Utah14, Memorial Sloan Kettering Cancer Center15
TL;DR: This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
Abstract: Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
1,545 citations
Cleveland Clinic1, University of Texas Health Science Center at San Antonio2, Fred Hutchinson Cancer Research Center3, University of Colorado Denver4, National Institutes of Health5, Harvard University6, University of Texas MD Anderson Cancer Center7, Mayo Clinic8, Duke University9, University of Toronto10, University of California, San Diego11, University of Western Ontario12, University of California, Irvine13, University of Michigan14
TL;DR: Dietary supplementation with vitamin E significantly increased the risk of prostate cancer among healthy men in relatively healthy men.
Abstract: Context The initial report of the Selenium and Vitamin E Cancer Prevention Trial (SELECT) found no reduction in risk of prostate cancer with either selenium or vitamin E supplements but a statistically nonsignificant increase in prostate cancer risk with vitamin E. Longer follow-up and more prostate cancer events provide further insight into the relationship of vitamin E and prostate cancer. Objective To determine the long-term effect of vitamin E and selenium on risk of prostate cancer in relatively healthy men. Design, Setting, and Participants A total of 35 533 men from 427 study sites in the United States, Canada, and Puerto Rico were randomized between August 22, 2001, and June 24, 2004. Eligibility criteria included a prostate-specific antigen (PSA) of 4.0 ng/mL or less, a digital rectal examination not suspicious for prostate cancer, and age 50 years or older for black men and 55 years or older for all others. The primary analysis included 34 887 men who were randomly assigned to 1 of 4 treatment groups: 8752 to receive selenium; 8737, vitamin E; 8702, both agents, and 8696, placebo. Analysis reflect the final data collected by the study sites on their participants through July 5, 2011. Interventions Oral selenium (200 μg/d from L-selenomethionine) with matched vitamin E placebo, vitamin E (400 IU/d of all rac-α-tocopheryl acetate) with matched selenium placebo, both agents, or both matched placebos for a planned follow-up of a minimum of 7 and maximum of 12 years. Main Outcome Measures Prostate cancer incidence. Results This report includes 54 464 additional person-years of follow-up and 521 additional cases of prostate cancer since the primary report. Compared with the placebo (referent group) in which 529 men developed prostate cancer, 620 men in the vitamin E group developed prostate cancer (hazard ratio [HR], 1.17; 99% CI, 1.004-1.36, P = .008); as did 575 in the selenium group (HR, 1.09; 99% CI, 0.93-1.27; P = .18), and 555 in the selenium plus vitamin E group (HR, 1.05; 99% CI, 0.89-1.22, P = .46). Compared with placebo, the absolute increase in risk of prostate cancer per 1000 person-years was 1.6 for vitamin E, 0.8 for selenium, and 0.4 for the combination. Conclusion Dietary supplementation with vitamin E significantly increased the risk of prostate cancer among healthy men. Trial Registration Clinicaltrials.gov Identifier: NCT00006392
1,448 citations
Journal Article•
1,347 citations
TL;DR: Adjuvant radiotherapy after radical prostatectomy for a man with pT3N0M0 prostate cancer significantly reduces the risk of metastasis and increases survival.
1,117 citations
Cites background from "Quality of life and satisfaction wi..."
...This gradual switch toward a superior quality of life in the adjuvant radiotherapy group should be examined in the context of the increased rates of PSA recurrence, salvage radiotherapy and hormonal therapy in the observation group, all of which have negative impacts on quality of life.(13,14) A limitation of this study is the incomplete central pathological review with only 311 of 425 (73%) men having a complete central pathological review....
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References
More filters
Book•
01 Jan 1983TL;DR: In this paper, a generalization of the analysis of variance is given for these models using log- likelihoods, illustrated by examples relating to four distributions; the Normal, Binomial (probit analysis, etc.), Poisson (contingency tables), and gamma (variance components).
Abstract: The technique of iterative weighted linear regression can be used to obtain maximum likelihood estimates of the parameters with observations distributed according to some exponential family and systematic effects that can be made linear by a suitable transformation. A generalization of the analysis of variance is given for these models using log- likelihoods. These generalized linear models are illustrated by examples relating to four distributions; the Normal, Binomial (probit analysis, etc.), Poisson (contingency tables) and gamma (variance components).
23,215 citations
Book•
01 Jan 1994
TL;DR: In this paper, a generalized linear model for longitudinal data and transition models for categorical data are presented. But the model is not suitable for categric data and time dependent covariates are not considered.
Abstract: 1. Introduction 2. Design considerations 3. Exploring longitudinal data 4. General linear models 5. Parametric models for covariance structure 6. Analysis of variance methods 7. Generalized linear models for longitudinal data 8. Marginal models 9. Random effects models 10. Transition models 11. Likelihood-based methods for categorical data 12. Time-dependent covariates 13. Missing values in longitudinal data 14. Additional topics Appendix Bibliography Index
7,156 citations
TL;DR: A class of statistical models that generalizes classical linear models-extending them to include many other models useful in statistical analysis, of particular interest for statisticians in medicine, biology, agriculture, social science, and engineering.
Abstract: Addresses a class of statistical models that generalizes classical linear models-extending them to include many other models useful in statistical analysis. Incorporates numerous exercises, both theoretical and data-analytic Discusses quasi-likelihood functions and estimating equations, models for dispersion effect, components of dispersion, and conditional likelihoods Holds particular interest for statisticians in medicine, biology, agriculture, social science, and engineering
5,678 citations
TL;DR: Generalized linear models, 2nd edn By P McCullagh and J A Nelder as mentioned in this paper, 2nd edition, New York: Manning and Hall, 1989 xx + 512 pp £30
Abstract: Generalized Linear Models, 2nd edn By P McCullagh and J A Nelder ISBN 0 412 31760 5 Chapman and Hall, London, 1989 xx + 512 pp £30
5,146 citations