Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer： a study on long-term patient outcome with risk stratification

Health-related quality-of-life （HRQOL） after a radical prostatectomy （RP） or extemal beam radiation therapy （EBRT） has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP （n = 86） and EBRT （n = 76） for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP （79%） and 54 EBRT （79%） patients over a 3-year follow-up period （median： 41 months） using the Medical Outcomes Study Short Form-36 （SF-36） and the University of Califomia Los Angeles Prostate Cancer Index （UCLA PCI）. The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk （74.6% vs. 75.0%, P = 0.931） and intermediate-risk （61.3% vs. 71.1%, P = 0.691） patients. For high-risk patients, progression-free survival was lower in the RP group （45.1%） than in the EBRT group （79.7%） （P = 0.002）. The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group （P 〈 0.001, P 〈 0.05 and P 〈 0.001, respectively）. With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group （P 〈 0.001 for each）. The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients （P 〈 0.001）. Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient＇s HRQOL after treatment did not depend on biochemical recurrence.

Vision-related quality-of-life in Jamaican glaucoma patients at Kingston Public Hospital

AIM: To determine the vision-related quality-of-life of glaucoma patients and the association between clinical and socioeconomic factors, and vision-related quality-of-life.METHODS: This was a cross-sectional study. Consecutive patients with glaucoma were interviewed using a modified 25-item National Eye Institute Visual Function Questionnaire(VFQ-25) by a single interviewer. Statistical analysis was done to find associations between patient variables and vision-related quality-of-life scores. Confidentiality and anonymity were maintained.RESULTS: Ninety-six participants were recruited in the study. There were 44 males and the mean age for males and females was 65.7 and 69.5y, respectively. The mean composite score was 71.2(with a maximum possible score of 100), with the highest mean score in the colour vision subscale(89.8) and the lowest mean score in the driving subscale(34.0). Worse visual acuity(P<0.001), longer duration of glaucoma(P<0.001) and higher number of glaucoma medications(P<0.001) were associated with a worse composite score. Female participants and those who lived in urban areas had significantly better scores than male participants(P=0.002) and those who lived in rural areas(P=0.017), respectively.CONCLUSION: The vision-related quality-of-life in Jamaican glaucoma patients is comparable to that of glaucoma patients in the Barbados Eye Study and other international studies using the VFQ-25 questionnaire. Worse quality-of-life scores are associated with poorer visual acuity, longer duration of glaucoma, more glaucoma medications, and sociodemographic factors such as male gender and rural residence.

Effects of physical exercise on the quality-of-life of patients with haematological malignancies and thrombocytopenia:A systematic review and meta-analysis

BACKGROUND Annually,there are an estimated 1187000 new patients worldwide diagnosed with haematological malignancies.Effective strategies are needed to alleviate side effects and prevent the physical and psychosocial degeneration of patients in active treatment for haematological malignancies.AIM To explore the effects of physical exercise on quality of life(Qo L)of patients with haematological malignancies and thrombocytopenia.METHODS Cochrane Library,Pub Med and Embase were searched for all relevant articles reporting randomized controlled trials(RCTs)that were published up to 31 July 2021.Two authors independently selected articles in accordance with the inclusion criteria,evaluated their quality,and collected information.Any controversy was resolved through discussion with a third senior author.The PRISMA 2009 checklist was followed.RESULTS Seven RCTs were selected in the systematic review and three were included in the final meta-analysis.There were significant differences in Qo L between physical exercise groups[mean score difference=8.81;95%confidence interval(CI):1.81-15.81,P=0.01],especially in emotional functioning(mean score difference=12.34;95%CI:4.64-20.04,P=0.002)and pain(mean score difference=–12.77;95%CI:-3.91 to-21.63,P=0.005).CONCLUSION Physical exercise has clinical effects on Qo L and improves emotional function and pain indices of patients with haematological malignancies and thrombocytopenia.

Ocular manifestations and quality of life in patients after hematopoietic stem cell transplantation

AIM:To explore the relationship between ocular and systemic conditions and the impact of ocular complications on the quality of life(QOL)in patients after allogeneic hematopoietic stem cell transplantation(ALLO-HSCT).METHODS:Forty-four patients with severe hematopoietic disease were enrolled after ALLO-HSCT at our center from July 2018 to October 2020.They completed two questionnaires:the Ocular Surface Disease Index(OSDI)and the quality-of-life scale for Chinese patients with visual impairment(SQOL-DV1).Ocular conditions and systemic conditions were also assessed.RESULTS:Eye damage was correlated with total bilirubin(P=0.005),and gamma-glutamyl transferase(GGT)(P=0.021).There was no significant correlation between the overall QOL score and OSDI(P=0.8226)or SQOLDV1(P=0.9526)scores.The OSDI and the overall QOL score were not correlated with ocular conditions,including best-corrected visual acuity(BCVA),intraocular pressure,Schirmer tear test II,sodium fluorescein staining,tear film breakup time,and tear meniscus height.SQOLDV1 was correlated with BCVA(P=0.0007),sodium fluorescein staining(P=0.007),and tear film breakup time(P=0.0146).CONCLUSION:In some patients,early ocular symptoms are not evident after ALLO-HSCT,while ocular surface complications can be observed after a comprehensive ophthalmological examination.Especially for those with elevated total bilirubin or GGT,regular ophthalmic follow-up visits are essential to diagnose and treat ocular graft versus host disease(o GVHD),especially for patients with elevated total bilirubin or GGT.

Development and predictive validity of the cirrhosis-associated ascites symptom scale: A cohort study of 103 patients

AIM To develop a scale of domains associated with the health-related quality-of-life(HRQOL) in patients with cirrhosis-related ascites.METHODS We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom(CAS) scale describing symptoms with a potential detrimental impact on health related quality of life(HRQL)(the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with(1) tense/severe;(2) moderate/mild; or(3) no ascites(controls). Patients also completed chronic liver disease questionnaire(CLDQ) and the Euro QoL 5-Dimensions 5-Level(EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS The final CAS scale included 14 items. The equivalent reliability was high(Chronbach's alpha 0.88). The validation cohort included 103 patients(72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls(mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites(mean = 23.8 points) as well as moderate/mild ascites(mean = 18.6 points)(P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score(rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score(0.67, P < 0.001). CONCLUSION The CAS is a valid tool, which reflects HRQOL in patients with ascites.

Quality of life scales for patients with gastroesophageal reflux disease:A literature review

Gastroesophageal reflux disease(GERD)is a common chronic disease of the gastrointestinal tract that occurs in 3.1%of the Chinese population[1].Heartburn,acid regurgitation and epigastric pain are typical clinical symptoms of GERD.These symptoms can affect patients'work productivity,sleep,diet and daily activities,thus resulting in a reduced quality of life(QOL)[2].Although patient QOL is increasingly being considered as a medical outcome index in the evaluation of the impact of GERD symptoms on patients'health status,measuring patient QOL in clinical trials can be challenging due to the lack of a standard assessment tool.Therefore,we aim to review the commonly used generic,disease-specific and hybrid QOL questionnaires to evaluate patients with GERD to provide a reference for clinical nursing work.

Direct anterior approach vs Hardinge in obese and nonobese osteoarthritic patients:A randomized controlled trial

BACKGROUND The increased prevalence of obesity has resulted in orthopedic surgeons being likely to face many patients with a high body mass index(BMI)who warrant total hip arthroplasties(THAs)over the coming years.Studies'findings considered the postoperative clinical,and functional outcomes in these patients are controversial,and selecting the most appropriate surgical approach remains debatable.AIM To compare pain-levels,functionality,and quality-of-life in obese and nonobese osteoarthritic patients who have undergone primary total hip arthroplasty through either direct-anterior-approach(DAA)or Hardinge-approach.METHODS One hundred and twenty participants(>50 years)were divided into four groups according to the surgical approach(DAA or Hardinge)and patients'BMI(nonobese<30 kg/m^(2)vs obese≥30 kg/m^(2)).Outcomes were measured preoperatively and postoperatively(6^(th)and 12^(th)week).Pain was measured with Face Pain Scale-Revised(FPS-R).Functionality was measured with Timed Up&Go(TUG)test and Modified Harris Hip Score-Greek version(MHHS-Gr).Quality-of-life was evaluated with the 12-item-International Hip Outcome Tool-Greek version(iHOT12-Gr)(Clinical Trial Identifier:ISRCTN15066737).RESULTS DAA vs Hardinge:(week 6)DAA-patients showed 12.2% less pain,more functionality(14.8% shorter TUG-performance time,21.5% higher MHHS-Gr),and 38.16% better quality-of-life(iHOT12-Gr)compared to Hardinge-patients(all P values<0.001).These differences were further increased on week 12(all P values≤0.05).DAA-obese vs Hardinge-obese:(week 6)DAA-obese patients had less pain,shorter TUG-performance time,better MHHS-Gr and iHOT12-Gr scores than Hardinge-obese(all P values<0.01).(Week 12)Only the TUG-performance time of DAA-obese was significantly shortened(22.57%,P<0.001).DAAnonobese vs DAA-obese:no statistically significant differences were observed comparing the 6th and 12th weeks'outcomes.CONCLUSION DAA-groups reported less pain,more functionality and better quality-of-life,compared to the Hardinge-groups.The DAA benefited obese and nonobese patients,similarly yet faster,suggesting that it should be the more preferred choice for obese patients,instead of Hardinge.However,more comparative studies with more extended follow-up periods are needed to confirm our results and better evaluate all patients'long-term outcomes.

Androgen-deprivation therapy alone versus combined with radiation therapy or chemotherapy For nonlocalized prostate cancer： a systematic review and meta-analysis

In this paper, we reviewed the long-term survival outcomes, safety, and quality-of-life of androgen-deprivation therapy （ADT） alone versus combined with radiation therapy （RT） or chemotherapy for locally advanced and metastatic prostate cancer （PCa）. A literature search was performed using OvidSP. Randomized controlled trials （RCTs） that met the following criteria were included： including locally advanced or metastatic PCa, comparing ADT alone versus combined with any treatment method and reporting quantitative data of disease control or survival outcomes. Finally, eight RCTs met the inclusion criteria. Among these, three compared ADT versus ADT plus RT （n = 2344） and one compared ADT versus ADT plus docetaxel-estramustine （n = 413） in locally advanced PCa; two compared ADT versus ADT plus docetaxel （n = 1175） and two compared ADT versus ADT plus estramustine （n = 114） in metastatic PCa. For locally advanced PCa, the addition of RT to long-term ADT can improve the outcomes of survival and tumor control with fully acceptable adverse effects. Specially, the pooled odds ratio （OR） of overall survival （OS） was 1.43 （95% confidence interval 1.20-1.71） when compared ADT plus RT with ADT alone （P 〈 0.0001）. For metastatic hormonally sensitive PCa, the concurrent use of docetaxel plus ADT was effective and safe （pooled OR of OS： 1.29 [1.01-1.65]： P = 0.04）. In all, long-term ADT plus RT and long-term ADT plus docetaxel should be considered as proper treatment option in locally advanced and metastatic hormonally sensitive PCa, respectively. The major limitation for the paper was that only eight RCTs were available.