Dissing Niklas, Fode Prof. Mikkel, Sønksen Prof. Jens, Østergren Dr. Peter B

(135) CHANGES IN QUALITY OF LIFE AND SEXUAL FUNCTION AFTER LHRH AGONISTS VS ORCHIECTOMY IN MEN WITH METASTATIC PROSTATE CANCER: RESULTS FROM A RANDOMIZED TRIAL

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives To examine changes in quality of life (QoL) in men diagnosed with metastatic prostate cancer randomly assigned to either medical or surgical castration. Methods Men with de novo metastatic prostate cancer were randomized (1:1) to either Triptorelin 22.5mg/24weeks or subcapsular orchiectomy as monotherapy. QoL and sexual function were assessed using the validated questionaries EORTC-QLQ-C30, EORTC-QLQ-PR25 and Erectile Hardness Scale (EHS) before treatment and at 12, 24 and 48 weeks. Outcomes were changes in overall QoL, functional and symptom scales. Data was analyzed using linier mixed models for repeated measures. Results Fifty-seven men with a median age of 74 years (range 47 to 86 years) were randomized and received allocated treatment from September 2013 through March 2015. The pooled analyses, combining data from both groups, showed that QoL (p=0.003), emotional function (p<0.001), urinary symptoms (p=0.011) and hormonal treatment related symptoms (p<0.001) changed significantly between visits. Improvement from baseline in QoL (mean change 6.8 points [95%CI 2.1; 11.5]), emotional function (6.9 points [3.3; 10.6]) and urinary symptoms (-7.7 points [-12.3; -3.0]) were observed at 24 weeks. Hormonal treatment related symptoms (8.9 points [95% CI 5.9; 12.0]) worsened. No significant differences between treatment groups in any of the scales were observed. At baseline, 29 men (51%) reported retained interest in sex and 18 were sexually active. At 12 weeks eight continued to report an interest in sex and six were sexually active. Three men had erections hard enough for penetration at baseline. This dropped to one man at 12 weeks. Conclusions Men with newly diagnosed metastatic prostate cancer experience improved QoL and emotional function at follow-up after starting androgen deprivation therapy. Urinary symptoms improve while hormonal treatment related symptoms worsened. Interest in sex and sexual activity was retained in a proportion of men despite androgen deprivation. Conflicts of Interest None.

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