Short-term QOL Scores Lower in Non-Hispanic Black Patients With Prostate Cancer After Radical Prostatectomy

Mara Koelker, MD

Among patients with prostate cancer who underwent radical prostatectomy, quality of life (QOL) scores were lower prior to surgery, 3 months after surgery, and 6 months after surgery for non-Hispanic Black men vs non-Hispanic White men, according to data from a retrospective study presented at the 2023 American Urological Association (AUA) Annual Meeting.

However, there was not a statistically significant difference between the two groups for QOL scores at 12 months and 24 months following surgery.

The retrospective study collected patient-reported outcomes (PROs) using the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire for men treated at a tertiary care center between 2015 and 2021 in the United States. Data showed that the differences in QOL scores between non-Hispanic Black patients and non-Hispanic White patients were 2.34 (95% CI, 0.36-4.31, P = .02) at baseline, 4.36 (95% CI, 2.29-6.42; P < .01) at 3 months following surgery, and 3.26 (95% CI, 1.10-5.43; P < .01) 6 months after surgery.

“[These findings] implicate that counseling prior to treatment should focus on the expectations [of treatment] and what to expect after treatment. Further, equitable access to rehabilitation programs might mitigate the racial differences that we found in our study,” Mara Koelker, MD, said.

In the interview with OncLive^®, Koelker, a resident at the University Medical Center Hamburg-Eppendorf, the University of Hamburg, in Hamburg, Germany, and former research fellow at the Brigham and Women’s Hospital, Harvard Medical School, in Boston, Massachusetts, discussed the rationale of evaluating racial differences in QOL for patients with prostate cancer and ways to address these short-term disparities in a real-world setting.

OncLive^®: Can you expand on the background for investigating racial differences in PROs for patients with prostate cancer who underwent radical prostatectomy?

Koelker: Prior comparative studies mostly focused on short-term outcomes, such as complications and oncological results. Only a smaller number of studies looked at patient-reported QOL.

Racial differences and disparities have been shown in access to care and outcomes for [patients with] prostate cancer. [However], the causes are not fully elucidated yet. Therefore, we aimed to look at PROs using the EPIC-CP questionnaire, which is a validated approach to measure patient-reported function and health-related QOL.

We retrospectively assessed the prospectively collected PRO measures. We used the EPIC-CP questionnaire to assess patient-reported QOL between 2015 and 2021. The primary endpoint was the overall QOL.

What were the key findings presented at the 2023 AUA Annual Meeting?

We had 3 main findings. First, the worst QOL for non-Hispanic White and non-Hispanic Black men was reported 3 months after [radical prostatectomy].

Second, we found a significant difference between non-Hispanic White and non-Hispanic Black men 3 and 6 months after surgery, with non-Hispanic Black men having worse QOL. However, in the long-term results 12 and 24 months after surgery, we did not find a significant difference [in QOL].

Third, most of the EPIC-CP [questionnaires] scored in the lowest quartile, which indicates an overall high QOL. From a practical standpoint, we highlighted that there were patient-reported differences in QOL after treatment for prostate cancer.

What next steps or other research avenues regarding racial differences in QOL for patients with prostate cancer would you like to explore in the future?

PROs allow us to measure what matters most to our patients, and we could implement [PROs] in real time as a feedback tool for our clinic and other clinics to allow us to offer the highest quality of care and equity for all men treated for prostate cancer.

Reference

Koelker M, Labban M, Frego N, et al. Racial differences in patient-reported outcomes among men treated with radical prostatectomy for prostate cancer. Presented at: 2023 AUA Annual Meeting. April 27-May 1, 2023; Chicago, IL. Abstract MP80-17.