In the field of uro-oncology, the assessment of quality of life (QoL) is considered
an integral part of clinical research. Because of the rarity of penile cancer, there
is currently no cancer-specific questionnaire module available to assess the tumor-specific
loss of function and symptoms in terms of influencing QoL. The aim of the study was
to apply a validated questionnaire (European Organization for Research and Treatment
of Cancer [EORTC] QLQ-C30) in a population of patients diagnosed with penile cancer
and to compare these results to reference data of the general population. We also
developed a new unvalidated questionnaire (Quality of Life Questionnaire–Penile Cancer–Rostock,
HRO-PE29) in this population to promote QoL research in the field of uro-oncology.
Patients and Methods
Cross-sectional evaluation of patients with penile cancer after local surgical treatment
(n = 76) was performed using EORTC QLQ-C30 and HRO-PE29. The QLQ-C30 provides information
on QoL, functional scales, symptom scales, and 6 individual items (inappetence, insomnia,
dyspnea, constipation, diarrhea, financial difficulties). Cancer-specific functional
and symptom scales (HRO-PE29) were then established for use in different disease states
and forms of treatment. These provide information on QoL as well as on cancer-specific
function and symptom scores.
The global QoL score was 54, which corresponds to an average QoL (score 0-100) and
was well below the age-standardized average for German patients. For the general function
scores, the following mean values were determined: physical ( = 73), social ( = 61), emotional ( = 60), cognitive functioning ( = 69), and role function ( = 63). With regard to the general symptom scores and the individual items, the following
values were found: fatigue ( = 35), nausea ( = 6), pain ( = 27), dyspnea ( = 23), insomnia ( = 41), loss of appetite ( = 25), constipation ( = 19), diarrhea ( = 10), and financial difficulties ( = 25). The following mean values were found for the cancer-specific functional scores:
voiding ( = 77), sexuality ( = 69, function and pleasure), body image ( = 64), lymphedema ( = 75), future prospects ( = 72), and adverse effects of systemic treatment ( = 73).
Defects of the external genitalia have implications for identity, personality, and
interpersonal relationships. The mental stress of these patients results from the
diagnosis of cancer as well as the partly mutilating treatment. Reconstructive surgery
in penile cancer patients promises to maintain sexual and micturition function and
thus improve QoL. Cancer-specific functional losses can be sufficiently named and
their influence on QoL determined.