Impact of comorbidity on patient reported outcome measures for men with localised prostate cancer.

BACKGROUND: Urinary and sexual function are impacted by prostate cancer treatment but also by comorbidities. We aimed to report the impact of comorbidities on functional outcomes after prostate cancer treatment. METHODS: We used patient reported EPIC-26, at baseline and 12 months, from a multicenter, prospective international cohort. Forest plots were constructed for urinary and sexual function, according to treatment, age and comorbidities (heart disease, hypertension and diabetes mellitus). RESULTS: We identified 10,928 patients diagnosed with non-metastatic prostate cancer with complete PROMs at baseline and at 12 months. Urinary and sexual function at baseline varied with age and comorbidities, but the biggest impact on 12-month function was the treatment itself. Surgery had a greater impact on urinary function compared to radiotherapy, irrespective of comorbidities, but this was only observed for sexual function in those with no comorbidities. Men of younger age and those with no comorbidities had the best preservation of urinary and sexual function after treatment, but a floor effect was observed whereby those with better baseline sexual function reported larger post-treatment differences. CONCLUSIONS: The impact of age and comorbidity on functional outcomes after prostate cancer treatment is minimal when considered against the impact of the treatment itself.