Valentin H Meissner, Kolja Imhof, Matthias Jahnen, Lukas Lunger, Andreas Dinkel, Stefan Schiele, Donna P Ankerst, Jürgen E Gschwend, Kathleen Herkommer
{"title":"长期前列腺癌幸存者的衰弱及其与生活质量和情绪健康的关系","authors":"Valentin H Meissner, Kolja Imhof, Matthias Jahnen, Lukas Lunger, Andreas Dinkel, Stefan Schiele, Donna P Ankerst, Jürgen E Gschwend, Kathleen Herkommer","doi":"10.6004/jnccn.2024.7066","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Frailty is emerging as an important determinant for quality of life (QoL) and emotional health in older patients with cancer, and specifically in long-term prostate cancer survivors, but quantitative studies are lacking. The current study assesses the prevalence of frailty and its association with QoL and emotional health in long-term prostate cancer survivors after radical prostatectomy.</p><p><strong>Patients and methods: </strong>A total of 2,979 prostate cancer survivors from the multicenter German Familial Prostate Cancer cohort completed questionnaires on frailty (Groningen Frailty Indicator [GFI]), QoL (EORTC QoL Questionnaire-Core 30), and emotional health (anxiety/depression symptoms via the Patient Health Questionnaire-4). Modified Poisson regression analysis was used to assess factors associated with frailty.</p><p><strong>Results: </strong>Average patient age was 79.4 years [SD, 6.4 years] and average time since radical prostatectomy was 17.4 years [SD, 3.8 years]. Among the cohort, 33.1% (n=985) of patients were classified as frail (GFI ≥4). Frail patients reported worse emotional health than nonfrail patients (depression symptoms: 24.0% vs 4.0%; anxiety symptoms: 20.6% vs 2.0%; both P<.001) and lower QoL (mean [SD], 53.4 [19.2] vs 72.7 [16.0]); P<.001). Higher age (relative risk [RR], 1.02; 95% CI, 1.01-1.03) and worse depressive (RR, 1.18; 95% CI, 1.12-1.24) and anxiety symptoms (RR, 1.17; 95% CI, 1.11-1.23) were associated with frailty. Living in a partnership (RR, 0.76; 95% CI, 0.67-0.86) and a higher QoL (RR, 0.86 for a 10-point increase; 95% CI, 0.84-0.89) were associated with nonfrailty.</p><p><strong>Conclusions: </strong>In a large German cohort, every third long-term prostate cancer survivor after radical prostatectomy was frail. The association of frailty with lower QoL and poorer mental health indicates the need for an integrated care approach including further geriatric assessment and possible interventions to improve health outcomes targeted to frail patients.</p>","PeriodicalId":17483,"journal":{"name":"Journal of the National Comprehensive Cancer Network","volume":" ","pages":""},"PeriodicalIF":14.8000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frailty in Long-Term Prostate Cancer Survivors and Its Association With Quality of Life and Emotional Health.\",\"authors\":\"Valentin H Meissner, Kolja Imhof, Matthias Jahnen, Lukas Lunger, Andreas Dinkel, Stefan Schiele, Donna P Ankerst, Jürgen E Gschwend, Kathleen Herkommer\",\"doi\":\"10.6004/jnccn.2024.7066\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Frailty is emerging as an important determinant for quality of life (QoL) and emotional health in older patients with cancer, and specifically in long-term prostate cancer survivors, but quantitative studies are lacking. The current study assesses the prevalence of frailty and its association with QoL and emotional health in long-term prostate cancer survivors after radical prostatectomy.</p><p><strong>Patients and methods: </strong>A total of 2,979 prostate cancer survivors from the multicenter German Familial Prostate Cancer cohort completed questionnaires on frailty (Groningen Frailty Indicator [GFI]), QoL (EORTC QoL Questionnaire-Core 30), and emotional health (anxiety/depression symptoms via the Patient Health Questionnaire-4). Modified Poisson regression analysis was used to assess factors associated with frailty.</p><p><strong>Results: </strong>Average patient age was 79.4 years [SD, 6.4 years] and average time since radical prostatectomy was 17.4 years [SD, 3.8 years]. Among the cohort, 33.1% (n=985) of patients were classified as frail (GFI ≥4). Frail patients reported worse emotional health than nonfrail patients (depression symptoms: 24.0% vs 4.0%; anxiety symptoms: 20.6% vs 2.0%; both P<.001) and lower QoL (mean [SD], 53.4 [19.2] vs 72.7 [16.0]); P<.001). Higher age (relative risk [RR], 1.02; 95% CI, 1.01-1.03) and worse depressive (RR, 1.18; 95% CI, 1.12-1.24) and anxiety symptoms (RR, 1.17; 95% CI, 1.11-1.23) were associated with frailty. Living in a partnership (RR, 0.76; 95% CI, 0.67-0.86) and a higher QoL (RR, 0.86 for a 10-point increase; 95% CI, 0.84-0.89) were associated with nonfrailty.</p><p><strong>Conclusions: </strong>In a large German cohort, every third long-term prostate cancer survivor after radical prostatectomy was frail. 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引用次数: 0
摘要
背景：衰弱正在成为老年癌症患者，特别是长期前列腺癌幸存者生活质量（QoL）和情绪健康的重要决定因素，但缺乏定量研究。本研究评估了根治性前列腺切除术后长期前列腺癌幸存者的虚弱患病率及其与生活质量和情绪健康的关系。患者和方法：来自多中心德国家族性前列腺癌队列的2979名前列腺癌幸存者完成了衰弱（格罗宁根衰弱指标[GFI]）、生活质量（EORTC生活质量问卷- core 30）和情绪健康（患者健康问卷-4的焦虑/抑郁症状）的问卷调查。采用修正泊松回归分析评估与虚弱相关的因素。结果：患者平均年龄79.4岁[SD， 6.4岁]，根治性前列腺切除术后平均时间17.4年[SD， 3.8年]。在队列中，33.1% （n=985）的患者被分类为虚弱（GFI≥4）。体弱多病患者报告的情绪健康状况比非体弱多病患者差(抑郁症状：24.0% vs 4.0%；焦虑症状：20.6% vs 2.0%；结论：在一项大型德国队列研究中，根治性前列腺切除术后三分之一的长期前列腺癌幸存者身体虚弱。虚弱与较低的生活质量和较差的精神健康之间的关联表明，需要采取综合护理方法，包括进一步的老年评估和可能的干预措施，以改善针对虚弱患者的健康结果。
Frailty in Long-Term Prostate Cancer Survivors and Its Association With Quality of Life and Emotional Health.
Background: Frailty is emerging as an important determinant for quality of life (QoL) and emotional health in older patients with cancer, and specifically in long-term prostate cancer survivors, but quantitative studies are lacking. The current study assesses the prevalence of frailty and its association with QoL and emotional health in long-term prostate cancer survivors after radical prostatectomy.
Patients and methods: A total of 2,979 prostate cancer survivors from the multicenter German Familial Prostate Cancer cohort completed questionnaires on frailty (Groningen Frailty Indicator [GFI]), QoL (EORTC QoL Questionnaire-Core 30), and emotional health (anxiety/depression symptoms via the Patient Health Questionnaire-4). Modified Poisson regression analysis was used to assess factors associated with frailty.
Results: Average patient age was 79.4 years [SD, 6.4 years] and average time since radical prostatectomy was 17.4 years [SD, 3.8 years]. Among the cohort, 33.1% (n=985) of patients were classified as frail (GFI ≥4). Frail patients reported worse emotional health than nonfrail patients (depression symptoms: 24.0% vs 4.0%; anxiety symptoms: 20.6% vs 2.0%; both P<.001) and lower QoL (mean [SD], 53.4 [19.2] vs 72.7 [16.0]); P<.001). Higher age (relative risk [RR], 1.02; 95% CI, 1.01-1.03) and worse depressive (RR, 1.18; 95% CI, 1.12-1.24) and anxiety symptoms (RR, 1.17; 95% CI, 1.11-1.23) were associated with frailty. Living in a partnership (RR, 0.76; 95% CI, 0.67-0.86) and a higher QoL (RR, 0.86 for a 10-point increase; 95% CI, 0.84-0.89) were associated with nonfrailty.
Conclusions: In a large German cohort, every third long-term prostate cancer survivor after radical prostatectomy was frail. The association of frailty with lower QoL and poorer mental health indicates the need for an integrated care approach including further geriatric assessment and possible interventions to improve health outcomes targeted to frail patients.
期刊介绍：
JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care.
Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship.
JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.
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