Quantitative Analysis Of Quality Of Life And Influencing Factors In Patients Undergoing Laparoscopic Radical Prostatectom

Background: Prostate cancer is a common malignancy of the urinary tract.Surgery is the most important form of treatment for clinically localized prostate cancer,and its impact on patients’ quality of life should not be underestimated.As the survival time of patients after surgery increases,their attention to the quality of life after surgery has increased.The "stripping method" radical prostatectomy is a new type of surgery whose impact on quality of life has not been quantitatively evaluated compared to traditional radical prostatectomy.Determining the factors affecting the quality of life after surgery is of guiding importance in the clinical treatment of prostate cancer.Objective: This study uses the Fact-P scale to quantitatively assess patients’ quality of life before and after various surgical procedures,to compare the effect of radical prostatectomy and conventional radical prostatectomy on patients’ quality of life,and to analyze prognostic factors that affect patients’ quality of life after surgery.Methods: In this study,249 patients who underwent radical resection of prostate cancer outside the fascia in our hospital between January 2021 and October 2022 were divided into a "stripping" radical prostatectomy group(IG)and a conventional radical prostatectomy group(CG),according to the study.mode of operation and exclusion criteria.Fifteen clinical data were collected,including patient age,body mass index(BMI),hypertension,diabetes,prostate-specific antigen(PSA),and CT calcification.The Chinese FACT-P score(4th edition)was used in the questionnaire Patients 1 week before surgery and 6 months after surgery,and whether the patients’ subjective quality of life was significantly impaired was recorded separately.The differences between the two groups of data were compared using analysis of variance.The patients were divided into two groups according to whether the patients’ subjective quality of life decreased or not.Differences between the two groups were analyzed by one-factor analysis.Subjects with statistical differences were analyzed with multivariate logistic regression to predict factors based on which the subjective quality of life did not deteriorate after surgery.The ROC curve was used to determine the cut-off value of the preoperative FACT-P score that predicted the deterioration of patients’ subjective quality of life after radical prostatectomy.The difference was statistically significant(P < 0.05).Results: There were 45 cases of "stripping method" radical prostatectomy and147 cases of standard radical prostatectomy.There were no significant differences in age,BMI,hypertension,diabetes,hemoglobin,white blood cells,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,biochemical blood sugar,imaging prostate calcification,FACT-P scores between the two groups before the operation,and there were no statistical differences between the upper and lower incisional margins after the operation.There were significant statistical differences in the quality of life between the two groups.The preoperative FACT-P score was 119.56 ± 11.69 in the standard radical prostatectomy group and 119.82 ±12.03 in the "stripping" radical prostatectomy group(P=0.438);Postoperative FACT-P score: standard radical prostatectomy group 102.30 ± 6.75,"stripping" radical prostatectomy 110.15 ± 10.55(P<0.01).The subjective quality of life of patients decreased in 114 cases,but not in 78 cases.Through univariate analysis,the two groups found that there were differences in age,preoperative FACT-P score,postoperative FACT-P score,surgical method and PSA.Logistic regression showed that preoperative FACT-P score was an independent predictor of whether the subjective quality of life of patients decreased(OR=0.719,P<0.01),The area under the ROC curve of preoperative FACT-P score predicting whether the quality of life of patients after surgery will decline is 0.773(95% CI 0.703-0.843).When the preoperative score is less than 116,the probability of the quality of life of patients after surgery will not decline is high,with sensitivity of 87.7% and specificity of61.5%.Conclusion: "stripping" radical prostatectomy can protect the quality of life of patients after operation compared with traditional radical prostatectomy;The preoperative FACT-P score is an independent influencing factor to predict whether the subjective quality of life will decline.The patients with preoperative FACT-P score<116 have less possibility of postoperative quality of life decline.