Work

Mp04-12 Comorbidity Status as a Predictor of High-grade Disease in Men With Prostate Cancer

Year: 2016

Type: article

Abstract: INTRODUCTION AND OBJECTIVES: Men with adverse pathologic features or biochemical recurrence after radical prostatectomy (RP) often receive subsequent radiation therapy (RT).The immediate post-operative deficits and slow recovery of urinary incontinence (UI) and sexual function (SF) over 2 years post-RP are well documented.Furthermore, RT may also significantly impact the recovery of UI and SF, particularly when combined with RP.As such, RT is often delayed until UI shows improvement.We sought to evaluate urinary and sexual quality of life (QOL) outcomes in RP patients to assess whether early RT administration was associated with worse outcomes.METHODS: We retrospectively identified patients who underwent RP and received subsequent RT during 2004 to 2013.The final cohort contained 113 men who completed 3 validated quality of life questionnaires: (i) pre-RP, (ii) post RP, pre-RT, and (iii) post-RT.From 2004 to 2006 we used the UCLA PCI and switched to the UCLA PCI based EPIC-26 in 2007.Patients were stratified as having received (i) early RT (<1yr post-RP) and (ii) late RT (>1 year post-RP).EPIC-26 QOL outcomes for UI and SF were compared between groups.RESULTS: 44 (38.9%) and 69 (61.1%) of patients had early RT and late RT, respectively.Patient age, cancer stage, nerve sparing, and margin status were not significantly different between groups while Gleason score and D 0 Amico risk groups tended to be worse in the early RT group.Median time to post-RP RT in the early and late groups was 8 and 28 months, respectively.Pre-RP UI and SF QOL scores were not significantly different between groups (p¼0.128;0.199).There was no significant difference in change in UI between RT treatment groups (p¼0.166see figure 1).Sexual function was worse in the early RT group after RP and showed no significant change after initiating RT.In the late RT group, there was improvement after RP and then a decline after RT (p¼0.043see figure 1).CONCLUSIONS: Men receiving early versus late RT experienced significantly different SF QOL outcomes.RT appears to halt or worsen post-RP recovery of sexual function.Urinary incontinence was not significantly different between groups which may underscore the importance of our practice of waiting until continence has improved to initiate RT.

Source: The Journal of Urology

DOI: 10.1016/j.juro.2016.02.1947

Authors: Timothy Daskivich, Douglas Skarecky, Thomas Ahlering, Stephen Freedland

Language: English

Topic: Prostate Cancer Diagnosis and Treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: American Cancer Society, National Institutes of Health, National Cancer Institute

Awards: G2846134289, G3823201305, G4503733747, Impact of Urologist Practice Structure on Prostate Cancer Care