MP47-03 IMPACT OF ADDITIONAL RADIATION AND/OR ADT ON FUNCTIONAL OUTCOMES AFTER RADICAL PROSTATECTOMY
2017-04-01

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV1 Apr 2017MP47-03 IMPACT OF ADDITIONAL RADIATION AND/OR ADT ON FUNCTIONAL OUTCOMES AFTER RADICAL PROSTATECTOMY Pierre Tennstedt, Meike Adam, Derya Tilki, Thomas Steuber, Alexander Haese, Georg Salomon, Cordula Petersen, Hartwig Huland, Markus Graefen, Wolfgang Huber, and Thorsten Schlomm Pierre TennstedtPierre Tennstedt More articles by this author , Meike AdamMeike Adam More articles by this author , Derya TilkiDerya Tilki More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Alexander HaeseAlexander Haese More articles by this author , Georg SalomonGeorg Salomon More articles by this author , Cordula PetersenCordula Petersen More articles by this author , Hartwig HulandHartwig Huland More articles by this author , Markus GraefenMarkus Graefen More articles by this author , Wolfgang HuberWolfgang Huber More articles by this author , and Thorsten SchlommThorsten Schlomm More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1463AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While the optimal use and timing of secondary therapy after radical prostatectomy (RP) remain controversial, there are limited data on the patient-reported outcomes following multimodality therapy. Objective is to assess the impact of additional radiation (RT) and/or androgen deprivation therapy (ADT) on urinary continence, potency and quality of life (QoL) after RP. METHODS Among 13150 men treated by RP from 1992-2013, 905 underwent RP+RT, 407 RP+ADT and 688 RP+RT+ADT. Urinary function, sexual function and overall QoL were evaluated annually using self-administrated validated questionnaires. Propensity score-matched and bootstrap analyses were performed, and the distribution of all functional outcomes were analyzed as a function of time after RP. RESULTS Patients who received RP+RT had a 4% higher overall incontinence rate 3 years after surgery and 1% higher rate for severe incontinence (>3 pads/24h) compared to matched RP-only patients. ADT further increased the overall and severe incontinence rate by 4% and 3% compared to matched RP+RT patients. RP+RT was associated with a 18% lower rate of potency compared to RP alone, while RP+RT+ADT was associated with a further 17% reduction compared to RP+RT patients. Additional RT reduced QoL by 10% and additional ADT by a further 12% compared to RP only and RP+RT patients, respectively. The timing of RT after RP showed no influence on continence, but adjuvant compared to salvage RT was associated with significantly lower potency (37% vs 45%), but higher QoL (60% vs 56%). CONCLUSIONS Secondary RT and ADT after RP have an additive negative influence on urinary function, potency, and Qol. High-risk patients should be counseled on the potential net impairment in functional outcomes from multimodality treatment prior to RP. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e628-e629 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Pierre Tennstedt More articles by this author Meike Adam More articles by this author Derya Tilki More articles by this author Thomas Steuber More articles by this author Alexander Haese More articles by this author Georg Salomon More articles by this author Cordula Petersen More articles by this author Hartwig Huland More articles by this author Markus Graefen More articles by this author Wolfgang Huber More articles by this author Thorsten Schlomm More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...