zdmeЗдоровье мегаполисаCity Healthcare2713-2617ГБУ «НИИОЗММ ДЗМ»10.47619/2713-2617.zm.2025.v.6i3;109-118zdme-208Research ArticleОБЗОРЫREVIEWSОценка качества жизни и его предикторы у больных раком предстательной железыAssessment of Quality of Life and its Predictors in Prostate Cancer Patientshttps://orcid.org/0009-0002-7536-4725МаксимоваМ. И.MaksimovaM. I.

Максимова Мария Ивановна – аспирант кафедры урологии

127473, г. Москва, ул. Делегатская, д. 20, стр. 1

Maria I. Maximova – Postgraduate Student of the Department of Urology

20 Delegatskaya Street, Building 1, 127473, Moscow

maximova.uro@gmail.comhttps://orcid.org/0000-0001-5468-0011ВасильевА. О.VasilievA. O.

Васильев Александр Олегович – канд. мед. наук, ассистент кафедры урологии; врач-уролог, врач-онколог Московского урологического центра; ведущий специалист ОМО по урологии

127473, г. Москва, ул. Делегатская, д. 20, стр. 1

125284, г. Москва, 2-й Боткинский пр-д, д. 5

115088, г. Москва, ул. Шарикоподшипниковская, д. 9

Alexander O. Vasilyev – Cand. Sci. in Medicine, Assistant of the Department of Urology; urologist, oncologist of the Moscow Urology Center; leading specialist for urology, OMO Division

20 Delegatskaya Street, Building 1, 127473, Moscow

2-y Botkinsky pr-d, 5, 125284, Moscow

9, Sharikopodshipnikovskaya ul., 115088, Moscow

https://orcid.org/0000-0003-3299-0574ГоворовА. В.GovorovA. V.

Говоров Александр Викторович – д-р мед. наук, профессор РАН, профессор кафедры урологии; врач-уролог, врач-онколог, заведующий онкоурологическим отделением № 80 Московского урологического центра

127473, г. Москва, ул. Делегатская, д. 20, стр. 1

125284, г. Москва, 2-й Боткинский пр-д, д. 5

Alexander V. Govorov – Dr. Sci. in Medicine, Professor of the Russian Academy of Sciences, Professor of the Department of Urology; urologist, oncologist, Head of the Oncourological Department No. 80 at the Moscow Urological Center

20 Delegatskaya Street, Building 1, 127473, Moscow

2-y Botkinsky pr-d, 5, 125284, Moscow

https://orcid.org/0000-0002-6096-5723ПушкарьД. Ю.PushkarD. Yu.

Дмитрий Юрьевич Пушкарь – академик РАН, д-р мед. наук, профессор, заведующий кафедрой урологии

127473, г. Москва, ул. Делегатская, д. 20, стр. 1

125284, г. Москва, 2-й Боткинский пр-д, д. 5

Dmitry Yu. Pushkar – Academician of the Russian Academy of Sciences, Dr. Sci. in Medicine, Professor, Head of the Department of Urology

20 Delegatskaya Street, Building 1, 127473, Moscow

2-y Botkinsky pr-d, 5, 125284, Moscow

Российский университет медицины Минздрава РоссииRussian University of Medicine of the Ministry of Health of the Russian FederationРоссийский университет медицины Минздрава России; Московский многопрофильный научно-клинический центр им. С.П. Боткина Департамента здравоохранения города Москвы; Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города МосквыRussian University of Medicine of the Ministry of Health of the Russian Federation; Botkin Hospital of Moscow Healthcare Department; Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare DepartmentРоссийский университет медицины Минздрава России; Московский многопрофильный научно-клинический центр им. С.П. Боткина Департамента здравоохранения города МосквыRussian University of Medicine of the Ministry of Health of the Russian Federation; Botkin Hospital of Moscow Healthcare Department20251609202563109118Copyright © Максимова М.И., Васильев А.О., Говоров А.В., Пушкарь Д.Ю., 20252025Максимова М.И., Васильев А.О., Говоров А.В., Пушкарь Д.Ю.Maksimova M.I., Vasiliev A.O., Govorov A.V., Pushkar D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.city-healthcare.com/jour/article/view/208

Введение. Улучшение качества жизни (КЖ) стало равноценной целью лечения рака предстательной железы (РПЖ) наряду с продлением выживаемости. Цель настоящей работы – обзор научных исследований, посвященных оценке КЖ больных РПЖ на этапах до и после лечения. Поиск научных исследований проводился с использованием ведущих международных баз данных (PubMed, Scopus и Web of Science). Материал и методы. Проведен систематический поиск в PubMed, Scopus и Web of Science (2010–2025) по ключевым словам prostate cancer, quality of life, postoperative outcomes, predictors. В финальный анализ включено 17 оригинальных исследований. Использованы опросники EPIC-26/CP, EORTC QLQ-C30/PR25, FACT-P, PROMIS, FoP-Q-SF и др. Результаты. Неблагоприятные клинико-патологические предикторы КЖ: возраст ≥65 лет, коморбидность, балл Глисона ≥8 и предшествующая трансуретральная резекция простаты. Анатомические МРТ-маркеры надежно предсказывают длительную инконтиненцию и эректильную дисфункцию после робот-ассистированной простатэктомии. Психосоциальные факторы (усталость, страх рецидива, бессонница) оказывают сопоставимый с клиническими переменными вклад: высокая усталость увеличивает риск плохого физического здоровья, а страх рецидива снижает глобальный QLQ-C30 на ≥10 пунктов. Высокий социально-экономический статус и семейная поддержка смягчают ухудшение КЖ на ≈30%. Радикальные методы терапии (РПЭ, ДЛТ, АДТ) вызывают стойкие функциональные нарушения, но не влияют на психическое благополучие, если проводится активная реабилитация. Заключение. КЖ пациентов с РПЖ определяется многофакторным взаимодействием клинических, анатомических и психосоциальных предикторов.

Introduction. Improving quality of life (QoL) has become an objective equal in importance to prolonging survival in prostate cancer (PC). The objective of this work was to review the latest scientific studies assessing the QOL of patients with PC both before and after treatment. The search for scientific studies was conducted using leading international databases (PubMed, Scopus and Web of Science). Material and methods. A systematic search of PubMed, Scopus and Web of Science (2010 – 2025) was performed using the terms “prostate cancer”, “quality of life”, “postoperative outcomes”, “predictors”. 17 original studies were included. The list of questionnaires used included EPIC-26/CP, EORTC QLQ-C30/PR25, FACT-P, PROMIS and FoP-Q-SF. Results. Adverse clinicopathological predictors of poor QoL included age ≥ 65 years, multimorbidity, Gleason score ≥ 8 and prior TURP. Anatomic MRI-derived markers (short membranous urethra < 10 mm, prolonged pubic–apex length) reliably forecasted long-term incontinence and erectile dysfunction after robot-assisted prostatectomy. Psychosocial factors—fatigue, fear of cancer recurrence and insomnia–made a comparable impact: severe fatigue increased the odds of poor physical health, while high fear of recurrence reduced global QLQ-C30 scores by ≥ 10 points. High socioeconomic status and robust family support mitigate QoL deterioration by approximately 30 %. Radical treatments (prostatectomy, external-beam radiotherapy, androgen-deprivation therapy) produced persistent functional impairment yet did not worsen mental well-being when active rehabilitation programs were implemented. Conclusion. QoL in men with PC is shaped by a multifactorial interplay of clinical, anatomical and psychosocial predictors; integrating routine PROM screening with MRI-based nomograms and targeted psychosocial support enables truly personalized care.

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The authors declare that there are no conflicts of interest present.