Impact of sociodemographic and socioeconomic factors on functional and health-related quality of life outcomes 24 months after radical prostatectomy.

Abstract

Introduction and objectives: High socioeconomic status (SES) is associated with improved oncological outcomes across various cancer types, including prostate cancer. However, limited evidence exists regarding the impact of SES and lifestyle factors on patient-reported outcomes (PROs), including quality of life (QoL), health status (HS), and functional recovery following radical prostatectomy (RP).

Materials and methods: We conducted a retrospective single-center analysis of 327 patients undergoing RP (177 open, 150 robotic-assisted) assessing pre- and postoperative functional outcomes (QoL, HS, erectile function, continence). PROs were evaluated 24 months postoperatively. Correlations with sociodemographic, socioeconomic (ISEI-based SES, marital status, occupational status, hometown size), and lifestyle factors (physical activity, BMI, mental stress) were analyzed.

Results: Pathological features of locally advanced tumors correlated negatively with QoL and HS. Higher SES was significantly associated with improved continence, but not with QoL, HS, or erectile function. Pre-existing mental stress negatively affected both continence and HS. Regular physical activity correlated positively with QoL and HS. Multivariable regression confirmed these findings and identified mental stress, SES, partnership and physical activity as independent predictors of PROs.

Conclusion: Beyond adverse tumor pathology, mental stress adversely impacts functional recovery and subjective health. In contrast, physical activity and a stable partnership correlate with better PROs. These findings may inform personalized patient counseling to increase postoperative satisfaction.