Association of Short-term Patient-reported Outcomes with Long-term Oncologic Outcomes in Localized Prostate Cancer Patients Treated with Radiotherapy and ADT in a Randomized Controlled Trial.

ABSTRACT: Background Both oncologic outcomes and patient-reported outcomes are pivotal in prostate cancer (PCa). However, it remains unknown if there is any association between these two outcomes. In this secondary analysis of a randomized controlled trial, we investigated the association of short-term changes in patient-reported outcome with long-term event-free survival (EFS) and metastasis-free survival (MFS) in localized PCa. Methodology Localized PCa patients with Gleason score ≤7, clinical stage T1b-T3a, and PSA Results Overall, 393 patients had responded to baseline QoL questionnaire. One patient died and one patient had failure within 10 months. Therefore, 391 patients were eligible for the landmark analyses. After adjusting for age, Gleason score, PSA, performance status, and treatment group, CMD of urinary symptoms was associated with worse EFS (HR: 1.79, 95%CI: 1.21-2.65) and MFS (HR: 1.69, 95%CI: 1.11-2.57). Considering deaths as competing events, CMD of urinary symptoms was associated with a significant increase in the relative incidence of progression (subdistribution HR: 2.42, 95%CI: 1.12-5.20). However, no association was found between CMD of bowel symptoms and EFS or MFS. Conclusions In this study, short-term CMD of urinary symptoms was associated with significantly inferior EFS, MFS and increase in the relative incidence of progression. Further investigations are needed to explore the biological rationale of such association in the context of ADT and radiotherapy.