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Previous Volume 347:790-796 September 12, 2002 Number 11 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Walsh, P. C. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background We evaluated symptoms and self-assessments of quality of life in men with localized prostate cancer who participated in a randomized comparison between radical prostatectomy and watchful waiting.

Methods Between 1989 and 1999, a group of Swedish urologists randomly assigned men with localized prostate cancer to radical prostatectomy or watchful waiting. In this follow-up study, we obtained information from 326 of 376 eligible men (87 percent) concerning certain symptoms, symptom-induced distress, well-being, and the subjective assessment of quality of life by means of a mailed questionnaire.

Results Erectile dysfunction (80 percent vs. 45 percent) and urinary leakage (49 percent vs. 21 percent) were more common after radical prostatectomy, whereas urinary obstruction (e.g., 28 percent vs. 44 percent for weak urinary stream) was less common. Bowel function, the prevalence of anxiety, the prevalence of depression, well-being, and the subjective quality of life were similar in the two groups.

Conclusions The assignment of patients to watchful waiting or radical prostatectomy entails different risks of erectile dysfunction, urinary leakage, and urinary obstruction, but on average, the choice has little if any influence on well-being or the subjective quality of life after a mean follow-up of four years.

Source Information

From the Department of Oncology and Pathology (G.S., F.H., P.W.D.) and the Department of Medical Epidemiology (P.W.D.), Karolinska Institutet, Stockholm; the Department of Urology and the Center for Assessment of Medical Technology, University Hospital, Örebro (F.H., J.-E.J.); Center for Surgical Sciences, Karolinska Institutet and Oncologic Center, Stockholm (J.A.); and the Department of Urology (B.J.N.) and the Department of Surgery, Regional Oncology Center (L.H.), University Hospital, Uppsala — all in Sweden.

Address reprint requests to Dr. Steineck at Clinical Cancer Epidemiology, Radiumhemmet, Karolinska Institutet, 17176 Stockholm, Sweden, or at gunnar.steineck{at}onkpat.ki.se.

Full Text of this Article

Related Letters:

Prostatectomy or Watchful Waiting in Prostate Cancer
Blanker M. H., Bierma-Zeinstra S. M.A., Schouten B. W.V., Coen J. J., Zietman A. L., Shipley W. U., Gambacorti-Passerini C. B., Sala E. A., Sonpavde G., Stern S. D., Bill-Axelson A., Holmberg L.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:170-171, Jan 9, 2003. Correspondence

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