Radical prostatectomy linked to worse urinary incontinence but not worse sexual function for men with favorable, unfavorable prognosis
By Elana Gotkine HealthDay Reporter
MONDAY, Jan. 29, 2024 (HealthDay News) — For patients with localized prostate cancer, the rates of adverse outcomes associated with specific treatments vary for favorable- and unfavorable-prognosis disease, according to a study published online in the Jan. 23/30 issue of the Journal of the American Medical Association.
Bashir Al Hussein Al Awamlh, M.D., from Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues conducted an observational cohort study using data from five U.S. Surveillance, Epidemiology, and End Results Program registries to compare rates of adverse functional outcomes between specific treatments for localized prostate cancer. At baseline, 1,877 and 568 participants had favorable- and unfavorable-prognosis prostate cancer. Treatment included radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance for favorable-prognosis disease (1,043, 359, 96, and 379, respectively) and radical prostatectomy or external beam radiotherapy with androgen deprivation therapy for unfavorable-prognosis disease (362 and 206, respectively). Patients were followed for a median of 9.5 years.
The researchers found that compared with active surveillance, radical prostatectomy was associated with worse urinary incontinence but not sexual function among men with a favorable prognosis. Among those with an unfavorable prognosis, radical prostatectomy was associated with worse urinary incontinence but not sexual function compared with external beam radiotherapy with androgen deprivation therapy. Worse bowel and hormone function were seen for those with an unfavorable prognosis receiving external beam radiotherapy with androgen deprivation therapy compared with radical prostatectomy.
“In this observational study of patients with localized prostate cancer followed up for approximately 10 years, functional outcomes varied by treatment and prognosis at the time of diagnosis,” the authors write.
Several authors disclosed ties to the biopharmaceutical industry.
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