One-year urinary and sexual outcome trajectories among prostate cancer patients treated by radical prostatectomy: a prospective study

BMC Urology

Jung Ae Lee¹  Kathleen Y. Wolin²  Emily Heer³  Eric H. Kim³  Lin Yang⁴  Claire Pernar⁵  Siobhan Sutcliffe⁶  Ratna Pakpahan⁶  Graham A. Colditz⁶  Kellie R. Imm⁷  Robert L. Grubb⁸  Adam S. Kibel⁹ 

[1] Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, USA;Coeus Health, Chicago, IL, USA;Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, T2S 3C3, Calgary, AB, Canada;Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, T2S 3C3, Calgary, AB, Canada;Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada;Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 600 S. Taylor Ave., 2nd floor, Rm. 208S, 63110, St. Louis, MO, USA;Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 600 S. Taylor Ave., 2nd floor, Rm. 208S, 63110, St. Louis, MO, USA;Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Campus Box 8100, 600 S. Taylor Ave., 2nd floor, Rm. 208S, 63110, St. Louis, MO, USA;Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, 2001 N Soto St., 90032, Los Angeles, CA, USA;Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, USA;Department of Urology, Medical University of South Carolina, Charleston, USA;Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Boston, USA;

关键词: Localized prostate cancer;    Benign prostatic hyperplasia;    Radical prostatectomy;    Urinary outcome;    Sexual outcome;   

DOI  :  10.1186/s12894-021-00845-0

来源: Springer

【 摘 要 】

BackgroundTo examine one-year trajectories of urinary and sexual outcomes, and correlates of these trajectories, among prostate cancer patients treated by radical prostatectomy (RP).MethodsStudy participants were recruited from 2011 to 2014 at two US institutions. Self-reported urinary and sexual outcomes were measured at baseline before surgery, and 5 weeks, 6 months and 12 months after surgery, using the modified Expanded Prostate Cancer Index Composite-50 (EPIC-50). Changes in EPIC-50 scores from baseline were categorized as improved (beyond baseline), maintained, or impaired (below baseline), using previously-reported minimum clinically important differences.ResultsOf the 426 eligible participants who completed the baseline survey, 395 provided data on at least one EPIC-50 sub-scale at 5 weeks and 12 months, and were analyzed. Although all mean EPIC-50 scores declined markedly 5 weeks after surgery and then recovered to near (incontinence-related outcomes) or below (sexual outcomes) baseline levels by 12 months post-surgery, some men experienced improvement beyond their baseline levels on each sub-scale (3.3–51% depending on the sub-scale). Having benign prostatic hyperplasia (BPH) at baseline (prostate size ≥ 40 g; an International Prostate Symptom Index Score ≥ 8; or using BPH medications) was associated with post-surgical improvements in voiding dysfunction-related bother at 5 weeks (OR = 3.9, 95% CI: 2.1–7.2) and 12 months (OR = 3.3, 95% CI: 2.0–5.7); and in sexual bother at 5 weeks (OR = 5.7, 95% CI:1.7–19.3) and 12 months (OR = 3.0, 95% CI: 1.2–7.1).ConclusionsOur findings provide additional support for considering baseline BPH symptoms when selecting the best therapy for early-stage prostate cancer.

【 授权许可】

CC BY