Population-based study of long-term functional outcomes after prostate cancer treatment Journal Article


Authors: Carlsson, S.; Drevin, L.; Loeb, S.; Widmark, A.; Lissbrant, I. F.; Robinson, D.; Johansson, E.; Stattin, P.; Fransson, P.
Article Title: Population-based study of long-term functional outcomes after prostate cancer treatment
Abstract: Objective To evaluate long-term urinary, sexual and bowel functional outcomes after prostate cancer treatment at a median (interquartile range) follow-up of 12 (11-13) years. Patients and Methods In this nationwide, population-based study, we identified 6 003 men diagnosed with localized prostate cancer (clinical local stage T1-2, any Gleason score, prostate-specific antigen <20 ng/mL, NX or N0, MX or M0) between 1997 and 2002 from the National Prostate Cancer Register, Sweden. The men were aged <= 70 years at diagnosis. A control group of 1 000 men without prostate cancer were also selected, matched for age and county of residence. Functional outcomes were evaluated with a validated self-reported questionnaire. Results Responses were obtained from 3 937/6 003 cases (66%) and 459/1 000 (46%) controls. At 12 years after diagnosis and at a median age of 75 years, the proportion of cases with adverse symptoms was 87% for erectile dysfunction/sexual inactivity, 20% for urinary incontinence and 14% for bowel disturbances. The corresponding proportions for controls were 62, 6 and 7%, respectively. Men with prostate cancer, except those on surveillance, had an increased risk of erectile dysfunction compared with the men in the control group. Radical prostatectomy was associated with an increased risk of urinary incontinence (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.36-2.62) and radiotherapy increased the risk of bowel dysfunction (OR 2.46, 95% CI 1.73-3.49) compared with men in the control group. Multimodal treatment, in particular treatment including androgen deprivation therapy (ADT), was associated with the highest risk of adverse effects; for instance, radical prostatectomy followed by radiotherapy and ADT was associated with an OR of 3.74 (95% CI 1.76-7.95) for erectile dysfunction and an OR of 3.22 (95% CI 1.93-5.37) for urinary incontinence. Conclusion The proportion of men who experienced a long-term impact on functional outcomes after prostate cancer treatment was substantial.
Keywords: quality of life; prostate cancer; sweden; register; radical prostatectomy; erectile dysfunction; urinary incontinence; surveillance; quality-of-life; urinary; index; prostatic; neoplasms/therapy
Journal Title: BJU International
Volume: 117
Issue: 6B
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2016-06-01
Start Page: E36
End Page: E45
Language: English
ACCESSION: WOS:000377589100004
DOI: 10.1111/bju.13179
PROVIDER: wos
PMCID: PMC4637260
PUBMED: 25959859
Notes: Article -- Source: Wos
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  1. Sigrid Viktoria Carlsson
    136 Carlsson