Quality of Life Research

, Volume 20, Issue 1, pp 111–118 | Cite as

Long-term quality of life following primary treatment in men with clinical stage T3 prostate cancer

  • Shunichi Namiki
  • Tatsuo Tochigi
  • Shigeto Ishidoya
  • Akihiro Ito
  • Isao Numata
  • Yoichi Arai



We evaluated the changes of health-related quality of life (HRQOL) during the 5 years after radical prostatectomy (RP) or external beam radiation therapy (EBRT) for clinical stage T3 prostate cancer (cT3PC).

Patients and methods

A total of 750 patients who underwent RP (n = 575) or EBRT (n = 175) participated in our longitudinal outcomes study. Of these patients, 48 RP patients (8%) and 63 EBRT patients (36%) presented with cT3PC and were included in this analysis. Patients completed the general and disease-specific HRQOL with the Short Form 36 (SF-36) and University of California, Los Angeles Prostate Cancer Index, respectively.


When examining the mean SF-36 values by time, there was significant impact on treatment outcomes for several items of the general HRQOL in the RP subjects. Those who underwent EBRT reported no significant changes in the general HRQOL throughout the follow-up period. With regard to disease-specific HRQOL, the RP subjects had significantly worse urinary HRQOL post-operatively than the EBRT subjects (P < 0.001). The scores for sexual function declined over the 60 months, but more so in the RP group. The two groups showed similar bowel HRQOL scores throughout the follow-up periods.


Both primary treatments for cT3PC can offer satisfactory functional outcomes from the HRQOL perspective, except for a persistent decrease in the sexual activity score. These results may guide the treatment selection and clinical management of patients with HRQOL impairments after treatment for cT3PC.


T3 prostate cancer Quality of life Radical prostatectomy External beam radiation therapy 



Androgen deprivation therapy


Analyses of variance


Clinical stage T3 prostate cancer


External beam radiation therapy


Health-related quality of life


Intensity-modulated radiation therapy


Prostate-specific antigen


Radical prostatectomy


Standard deviation


RAND 36-Item Short Form


University of California, Los Angeles Prostate Cancer Index


3-dimensional conformal therapy



We thank Emiko Izutsu, Tohoku University Hospital, who assisted in data collection and management.


  1. 1.
    Cancer Registration Committee of the Japanese Urological Association (2005) Clinicopathological statistics on registered prostate cancer patients in Japan: 2000 report from the Japanese Urological Association. Int J Urol, 12, 46–61.Google Scholar
  2. 2.
    Ward, J. F., Slezak, J. M., Blute, M. L., Bergstralh, E. J., & Zincke, H. (2005). Radical prostatectomy for clinically advanced (cT3) prostate cancer since the advent of prostate-specific antigen testing: 15-year outcome. BJU Int, 95, 751–756.CrossRefPubMedGoogle Scholar
  3. 3.
    van den Ouden, D., Hop, W. C., & Schröder, F. H. (1998). Progression in and survival of patients with locally advanced prostate cancer (T3) treated with radical prostatectomy as monotherapy. Journal of Urology, 160, 1392–1397.CrossRefPubMedGoogle Scholar
  4. 4.
    Granfors, T., Modig, H., Damber, J. E., & Tomic, R. (2006). Long-term followup of a randomized study of locally advanced prostate cancer treated with combined orchiectomy and external radiotherapy versus radiotherapy alone. Journal of Urology, 176, 544–547.CrossRefPubMedGoogle Scholar
  5. 5.
    Litwin, M. S., Shpall, A. I., Dorey, F., & Nguyen, T. H. (1998). Quality-of-life outcomes in long-term survivors of advanced prostate cancer. American Journal of Clinical Oncology, 21, 327–332.CrossRefPubMedGoogle Scholar
  6. 6.
    White, W. M., Sadetsky, N., Waters, W. B., Carroll, P. R., & Litwin, M. S. (2008). Quality of life in men with locally advanced adenocarcinoma of the prostate: An exploratory analysis using data from the CaPSURE database. Journal of Urology, 180, 2409–2413.CrossRefPubMedGoogle Scholar
  7. 7.
    Hays, R. D., Sherbourne, C. D., & Mazel, R. M. (1993). The RAND 36-item health survey 1.0. Health Economics, 2, 217–227.CrossRefPubMedGoogle Scholar
  8. 8.
    Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefPubMedGoogle Scholar
  9. 9.
    Litwin, M. S., Hays, R. D., Fink, A., Ganz, P. A., Leake, B., & Brook, R. H. (1998). The UCLA Prostate Cancer Index: Development, reliability, and validity of a health-related quality of life measure. Medical Care, 36, 1002–1012.CrossRefPubMedGoogle Scholar
  10. 10.
    Fukuhara, S., Ware, J., & Koshinski, M. (1998). Psychometric and clinical tests of validity of the Japanese SF-36 health survey. Journal of Clinical Epidemiology, 51, 1045–1053.CrossRefPubMedGoogle Scholar
  11. 11.
    Kakehi, Y., Kamoto, T., Osamu, O., Arai, Y., Litwin, M. S., & Fukuhara, S. (2002). Development Japanese version of the UCLA Prostate Cancer Index: A pilot validation study. Int J Clin Oncol, 7, 306–311.PubMedGoogle Scholar
  12. 12.
    Walsh, P. C. (2002). Anatomical radical retropubic prostatectomy. In P. C. Walsh, A. B. Retik, A. D. Vaughan, & A. J. Wein (Eds.), Campbell’s urology (8th ed., pp. 3107–3129). Philadelphia: WB Saunders.Google Scholar
  13. 13.
    Britton, K. R., Takai, Y., Mitsuya, M., Nemoto, K., Ogawa, Y., & Yamada, S. (2005). Evaluation of inter- and intrafraction organ motion during intensity modulated radiation therapy (IMRT) for localized prostate cancer measured by a newly developed on-board image-guided system. Radiation Medicine, 23, 14–24.PubMedGoogle Scholar
  14. 14.
    Litwin, M. S., Gore, J. L., Kwan, L., Brandeis, J. M., Lee, S. P., Withers, H. R., et al. (2007). Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer, 109, 2239–2247.CrossRefPubMedGoogle Scholar
  15. 15.
    Malcolm, J. B., Fabrizio, M. D., Barone, B. B., Given, R. W., Lance, R. S., Lynch, D. F., et al. (2010). Quality of life after open or robotic prostatectomy, cryoablation or brachytherapy for localized prostate cancer. Journal of Urology, 183, 1822–1828.CrossRefPubMedGoogle Scholar
  16. 16.
    Loeb, S., Smith, N. D., Roehl, K. A., & Catalona, W. J. (2007). Intermediate-term potency, continence, and survival outcomes of radical prostatectomy for clinically high-risk or locally advanced prostate cancer. Urology, 69, 1170–1175.CrossRefPubMedGoogle Scholar
  17. 17.
    Namiki, S., Ishidoya, S., Ito, A., Kawamura, S., Tochigi, T., Saito, S., et al. (2009). Quality of life after radical prostatectomy in Japanese men: a 5-year follow up study. International Journal of Urology, 16, 75–81.CrossRefPubMedGoogle Scholar
  18. 18.
    Lubeck, D. P., Grossfeld, G. D., & Carroll, P. R. (2001). The effect of androgen deprivation therapy on health-related quality of life in men with prostate cancer. Urology, 58(Suppl. 2A), 94–100.CrossRefPubMedGoogle Scholar
  19. 19.
    Akaza, H., Hinotsu, S., Usami, M., Ogawa, O., Kagawa, S., Kitamura, T., et al. (2006). The case for androgen deprivation as primary therapy for early stage disease: Results from J-CaP and CaPSURE. Journal of Urology, 176, S47–S49.CrossRefPubMedGoogle Scholar
  20. 20.
    Litwin, M. S., Sadetsky, N., Pasta, D. J., & Lubeck, D. P. (2004). Bowel function and bother after treatment for early stage prostate cancer: A longitudinal quality of life analysis from CaPSURE. Journal of Urology, 172, 515–519.CrossRefPubMedGoogle Scholar
  21. 21.
    Namiki, S., Ishidoya, S., Ito, A., Tochigi, T., Numata, I., Narazaki, K., et al. (2009). Five-year follow-up of health-related quality of life after intensity-modulated radiation therapy for prostate cancer. Japanese Journal of Clinical Oncology, 39, 732–738.CrossRefPubMedGoogle Scholar
  22. 22.
    Zelefsky, M. J., Levin, E. J., Hunt, M., Yamada, Y., Shippy, A. M., Jackson, A., et al. (2008). Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. International Journal of Radiation Oncology, Biology, Physics, 70, 1124–1129.CrossRefPubMedGoogle Scholar
  23. 23.
    D’Amico, A. V., Manola, J., Loffredo, M., Renshaw, A. A., DellaCroce, A., & Kantoff, P. W. (2004). 6-month androgen suppression plus radiation therapy vs. radiation therapy alone for patients with clinically localized prostate cancer: A randomized controlled trial. JAMA, 292, 821–827.CrossRefPubMedGoogle Scholar
  24. 24.
    Heer, H. W., & O’sullivan, M. (2000). Quality of life asymptomatic men with nonmetastatic prostate cancer on androgen deprivation therapy. Journal of Urology, 163, 1743–1746.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Shunichi Namiki
    • 1
    • 3
  • Tatsuo Tochigi
    • 2
  • Shigeto Ishidoya
    • 1
  • Akihiro Ito
    • 1
  • Isao Numata
    • 3
  • Yoichi Arai
    • 1
  1. 1.Department of UrologyTohoku University Graduate School of MedicineAoba-ku, SendaiJapan
  2. 2.Department of UrologyMiyagi Cancer CenterNatoriJapan
  3. 3.Department of UrologyOsaki Citizen HospitalOsakiJapan

Personalised recommendations