Poster, Podium & Video Sessions
Presentation Authors: Andrew Wang, Paul McClain*, Robert Given, Norfolk, VA
Introduction: Prostate cancer therapy is known to affect urinary symptoms in men, and its effect on quality of life can depend upon which type of treatment is received. This study is a retrospective review of a large database of men who underwent surgical prostate cancer treatment to assess the impact of therapy on quality of life in prostate cancer patients.
Methods: A total of 501 patients who underwent treatment for prostate cancer at a single institution from 2004-2014 were reviewed. The patients in this database were stratified into three groups with respect to the type of therapy received--robot-assisted laparoscopic radical prostatectomy (RLP), brachytherapy, and cryotherapy. Urinary incontinence related quality of life (HRQoL) was assessed at baseline and again at 1-60 months after therapy using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Preoperative and postoperative urinary incontinence scores were compared using a Student's t-test.
Results: Baseline patient characteristics were similar between each treatment group. Diabetes was the only comorbidity correlated with urinary symptoms. Baseline urinary incontinence scores were 93.3, 94.5, and 88.2 in the RLP, brachytherapy, and cryotherapy groups, respectively with a significant difference between the RLP and cryotherapy groups (p = 0.046). Urinary incontinence worsened in all three groups at the first follow-up (2.2 months) after treatment (p < 0.0001). The corresponding scores at long term follow-up were 72.0 (p < 0.0001), 78.1 (p < 0.0001), and 83.1 (p = 0.165). The RLP group urinary incontinence improved over time, while the brachytherapy group incontinence did not change significantly after short term follow-up. Only the cryotherapy group achieved a return to baseline at mean follow-up of 17.3 months. No significant difference was found between mean urinary incontinence for RLP and brachytherapy at long-term follow-up (p = 0.128).
Conclusions: Due to the high survival of patients who receive treatment for prostate cancer, quality of life is a major concern when choosing therapy. All three types of prostate cancer treatment studied above cause a short-term worsening of urinary incontinence. Long term, RLP and brachytherapy are associated with worsening of urinary incontinence, whereas cryotherapy is associated with the least impact. Comparatively, RLP and brachytherapy yield similar post-therapy urinary incontinence outcomes.
Source Of Funding: none
Eastern Virginia Medical School
Paul McClain, M.D.; Resident Physician in Urology, Eastern Virginia Medical School, PGY-4
Medical school training: Wake Forest University School of Medicine
College: Wheaton College, Wheaton, Illinois
Research interests: Hypogonadism, surgery for localized prostate cancer, prostate cancer quality of life
Social activities: married to wife Madeline McClain. Three children: Vivienne, Clara and Kai. Enjoy sports including soccer, football, basketball and outdoor activities.
Tuesday, May 16
9:30 AM – 11:30 AM