Analysis of short-term quality of life in post-surgical androgen deprivation therapy in advanced prostate cancer: a comparison of bilateral sub-capsular orchidectomy and bilateral total orchidectomy
INTRODUCTION: The use of Androgen Deprivation Therapy (ADT) in treating advanced prostate cancer poses a host of challenges that can affect the health-related quality of life (HRQoL) of these patients. Previous studies have demonstrated poor quality of life (QoL) of patients after ADT; however, there is a scarcity of the literature which compares HRQoL following bilateral subcapsular orchidectomy (BSCO) and bilateral total orchidectomy (BTO) in sub-Saharan Africa. This study aimed to compare the HRQoL of patients with advanced prostate cancer following treatment with BSCO and BTO.
METHODS: A randomized, single blind study concerning 64 patients with advanced prostate cancer; the subjects were randomized into BTO and BSCO treatment groups. The study was conducted over a period of ten months at a tertiary hospital situated in the North-central zone of Nigeria. Structured and validated instruments (FACT-PI and Karnofsky) were used to assess HRQoL during patient follow-up visits over a period of six months to obtain data regarding HRQoL and patient satisfaction. Statistical analysis using a chi-squared test and paired t-test were done to allow the comparison of HRQoL assessment scores and patients’ satisfaction ratings between the two groups.
RESULTS: The mean age of the subjects were 71.63 ± 7.56 years and 70.06 ± 8.79 years for the BTO and BSCO group respectively (p = 0.449). Also, mean Gleason’s score was 7.44 vs. 7.31 respectively (p =0.714). Health Related QoL assessment with FACT-PI and Karnofsky showed significantly better outcome after BSCO (p < 0.001). Only 17% of the participants had psychological compromise after ADT.
CONCLUSION: The two techniques of orchidectomy differ significantly in their short term QoL response to treatment; BSCO was associated with better patient outcomes compared to BTO.
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