Open Access

ARTICLE

A systematic review of expanded prostate cancer index composite (EPIC) quality of life after surgery or radiation treatment

Tsz Kin Lee¹, Rodney Henry Breau², Ranjeeta Mallick³, Libni Eapen⁴

1 Department of Radiation Oncology, Christchurch Oncology Centre, Christchurch, New Zealand
2 Division of Urology, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
3 Clinical Epidemiology Program, The Ottawa Hospital - General Campus, Ottawa, Ontario, Canada
4 Department of Radiation Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Ontario, Canada
Address correspondence to Dr. Rodney Henry Breau, Surgical Oncology, Division of Urology, The Ottawa Hospital/University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6 Canada

Canadian Journal of Urology 2015, 22(1), 7599-7606.

Abstract

Introduction: The Expanded Prostate Cancer Index Composite (EPIC) is a validated and widely adopted instrument that measures patient quality of life. This study aims to describe and compare patient quality of life in the bowel, urinary, and sexual domains across different prostate cancer treatments.
Materials and methods: A systematic review of English articles published prior to 2012 was conducted. Peer reviewed articles reporting longitudinal EPIC data in a statistically analyzable form with clearly defined time points were included. Articles were assessed by content experts to ensure optimal treatment quality.
Screening of studies and extraction of data were completed using a predefined data abstraction tool. Data on bowel, urinary, and sexual domains were documented. Scores in each domain range from a low of 0 to a high of 100.
Results: Twenty-six articles, representing 8302 patients, were included. All treatments were associated with short term or long term reductions in urinary, bowel, and sexual domains. Surgery patients had better post-treatment bowel quality of life; however, average declines were small regardless of treatment. Post-treatment urinary incontinence scores were lower for surgery patients; while radiation patients had worse urinary irritation. Average urinary bother and function were similar between treatment groups at 18 months post-treatment. Surgery patients had better baseline sexual function. A greater decline in sexual function was observed in surgery patients compared to radiation patients.
Conclusions: Prostate cancer treatments have different impacts on patient quality of life and function. The magnitude of difference between treatment-related adverse effects may be important to patients when choosing therapy.

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