Do Epidemiological Parameters in Patients with Localized Prostate Cancer have an Influence on whether a Patient is Envisaged for Surgery or Brachytherapy?

Introduction: Only few studies comparing treatment outcome for patients with localized prostate cancer control their results for the possible confounding of demographic and clinical parameters. This fact prompted us to compare epidemiological data of patients before receiving brachytherapy (BT) to patients envisaged for radical prostatectomy (RP). Methodology: We looked at demographic and clinical data as well as standardized questionnaires for 856 patients. In a logistic regression analysis parameters proven to be significantly different in a university analysis were further analyzed. Results: Data of 676 patients (79%) could be evaluated. Patients before radical prostatectomy (RPP) scored best in physical functioning, role functioning and sexual activity. Patients planned for low-dose rate brachytherapy (LDR) indicated the biggest problems in partnership and sexuality. The health insurance status was not equally distributed. However, in a logistic regression analysis of patients envisaged for surgical treatment only age and physical functioning could be identified as independent factors that differ significantly between treatment groups (p<0.01), but not role functioning, sexual activity, status of health insurance, global health-related quality of life, level of education and mean PSA before treatment. Discussion: Comparative outcome studies for radical prostatectomy and brachytherapy ignore epidemiological differences. Our investigation demonstrate that younger age (odds ratio: 1.56) and higher scores of ‘physical functioning’ (odds ratio: 1.22) are strongly associated with a higher probability of receiving a surgical procedure when diagnosed with localized prostate cancer Conclusions: Comparative outcome studies for different treatment modalities have to control their data for epidemiological differences, especially for age and physical functioning.