OBJECTIVES: As novel therapies such as hormone treatment for castration-resistant prostate cancer are added to the reimbursement list of public healthcare insurance, treatment of this disease in Japan become more complex. Under these circumstances, health technology assessment -especially cost-utility analysis- is important in the decision-making process for prostate cancer treatment. This study measured and compared the health-related quality of life (hrQOL) of various treatments in Japan these remains scarce.

METHODS: This cross-sectional study used the general hrQOL instrument EQ-5D (EuroQol Five-Dimensional Questionnaire) and the disease-specific instrument FACT-P (Functional Assessment of Cancer Therapy-Prostate). Five hundred Japanese patients with prostate cancer were recruited from 5 hospitals (100 per hospital) and grouped according to ongoing treatment. Clinical data were obtained from the attending physicians, and FACT-P scores and EQ-5D utility values per treatment group were calculated. If the analysis of variance showed statistical significance, Mann-Whitney U test was used to compare the groups (p<0.05).

RESULTS: Self-administered questionnaires and clinical data were obtained for 453 patients; after excluding those with incomplete EQ-5D and FACT-P data, 443 patients were assessed. EQ-5D utility values were correlated with FACT-P scores (r = 0.56, p < 0.0001). The EQ-5D utility values and standard deviations (SD) were as follows: follow-up monitoring group (including watchful waiting and PSA active surveillance, n=121), 0.90 (0.13); hormonal therapy group (n=146), 0.86 (0.16); surgery group (n=42), 0.85 (0.16); and chemo-hormonal therapy group (n=25), 0.80 (0.18). FACT-P scores for the same groups were: 114.3 (17.7; n=114), 109.2 (20.0; n=144,), 109.2 (3.08; n=39), and 101.6 (4.16; n=24), respectively. The hrQOL values for all groups showed statistically significant differences relative to the follow-up monitoring group.

CONCLUSIONS: The hrQOL values derived in this study will assist the cost-utility analysis in the decision-making process for prostate cancer treatments. Further analyses are required to validate our findings.