Calidad de vida en pacientes con cáncer de próstata localizado luego de la prostatectomía radical: Estudio Multicéntrico

• Iñiguez Robles, Sebastián Andrés ^[1] ; Ávila Díaz, Cristóbal ^[2] ; Román Sobarzo, Juan Carlos ^[3] ; Walton Diaz, Annerleim ^[4] ; Aliaga De la Fuente, Alfredo ^[5] ; Vega Avalos, Andrés ^[4] ; Orellana Sepúlveda, Sebastián ^[5] ; Vilches Paez, Roberto ^[1]
  1. [1] Instituto Nacional del Cáncer, Santiago, Chile Hospital San José, Santiago, Chile Hospital Clínico Universidad de Chile, Santiago, Chile
  2. [2] Hospital Clínico Universidad de Chile, Santiago, Chile
  3. [3] Instituto Nacional del Cáncer, Santiago, Chile Hospital Clínico Universidad de Chile, Santiago, Chile
  4. [4] Instituto Nacional del Cáncer, Santiago, Chile
  5. [5] Instituto Nacional del Cáncer, Santiago, Chile Hospital San José, Santiago, Chile

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• Localización: Revista chilena de cirugía, ISSN-e 0718-4026, ISSN 0379-3893, Vol. 76, Nº. 5, 2024, págs. 464-474
• Idioma: español
• Títulos paralelos:
  • Quality of life in localized prostate cancer after radical prostatectomy:: multicenter study in chilean population
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  • español

    Introduction: Prostate cancer has an increasing incidence, with high survival rates in a localized stage, whereby quality of life has a high importance. Prospective studies have shown general impairment in quality of life in patients undergoing radical prostatectomy, with specific adverse effects at the urinary and sexual function. The objective of this study is to determine the alterations in quality of life in urinary and sexual function before and after radical prostatectomy, comparing the open and laparoscopic approaches. Methodology: Prospective and analytical study that included patients undergoing open or laparoscopic radical prostatectomy. Clinical variables, urinary and sexual quality of life were analyzed through patients-reported outcome measures (EPIC-CP and IIEF-EF) and social continence through the amount of pads/day. Measurements were made preoperatively and at 3, 6 and 12 months. Results: 68 patients were included (43 in PRL group and 25 in PRA group). At baseline 47.8% had alterations in urinary function and 56,7% in sexual function. In the follow-up, 73,5%, 64,6% and 62,5% of urinary incontinence were observed in the total of patients at 3, 6 and 12 months, respectively. We observed lower rates of urinary incontinence in the laparoscopic group but without a statistically significant difference. In social continence, continence rates of 69,1%, 82,8% and 89,3% were observed at 3, 6 and 12 months, respectively, with statistically significant differences between laparoscopic (90,5%) and open (69,6%) approach at 6 months (p = 0,04). In sexual function, 78,3% of erectile dysfunction were observed at 12 months of follow-up, with no difference between the laparoscopic (75%) and open (85,7%) approaches. Conclusion: Patients with prostate cancer have baseline alterations in urinary and sexual quality of life. Radical prostatectomy, open or conventional laparoscopic approach, generates an additional deterioration in quality of life in these settings. Laparoscopic approach is associated with lower rates of postoperative urinary incontinence, with significant improvement in social continence at 6 months compared to open surgery. The approach route did not show differences in erectile function at 1 year of follow-up in this series.

  • español

     Introducción: El Cáncer de Próstata (CP) localizado tiene una alta sobrevida, siendo la calidad de vida (CdeV) de gran importancia. La prostatectomía radical (PR) altera la CdeV urinaria y sexual. El objetivo de este estudio es determinar deterioro en función urinaria y sexual antes y después de la PR comparando abordaje abierto (PRA) y laparoscópico (PRL). Metodología: Estudio prospectivo y analítico que incluyó pacientes sometidos a PRA y PRL. Se analizaron CdeV (encuestas IIEF-EF y EPIC-CP) y continencia social (CS). Las mediciones se realizaron en el preoperatorio y a los 3, 6 y 12 meses. Resultados: Se incluyeron 68 pacientes (43 PRL y 25 PRA). En forma basal 47.8% tuvo alteración en función urinaria y 56.7% en función sexual. En el seguimiento hubo 73.5%, 64.6% y 62.5% de incontinencia urinaria (IU) a 3, 6 y 12 meses, respectivamente, con menores tasas de IU para PRL, pero sin diferencias estadísticamente significativas. Se observó 69.1%, 82.8% y 89.3% de CS a 3, 6 y 12 meses, respectivamente, con diferencias estadísticamente significativas entre PRL (90.5%) y PRA (69.6%) a 6 meses (p=0.04). En función sexual hubo 78.3% de disfunción eréctil a 12 meses, sin diferencias (p=0.56) entre los grupos. Conclusiones: Los pacientes con CP tienen alteraciones basales en CdeV urinaria y sexual, que se exacerban con la PR. La PRL genera menos IU postoperatoria, con una mejoría significativa en CS a los 6 meses en comparación con PRA. La vía de abordaje no demostró diferencias en función eréctil a 1 año de seguimiento.