Long-term functional outcomes after treatment for localized prostate cancer

Area of Science:

• Urology
• Oncology
• Medical Outcomes Research

Background:

• Prostate cancer treatment significantly impacts patient quality of life.
• Understanding long-term functional outcomes is crucial for treatment decision-making.

Purpose of the Study:

• To compare long-term urinary, bowel, and sexual function after radical prostatectomy versus external-beam radiation therapy for localized prostate cancer.

Main Methods:

• Analysis of 1655 men (55-74 years) from the Prostate Cancer Outcomes Study (PCOS) diagnosed in 1994-1995.
• Comparison of functional status (urinary, bowel, sexual) at baseline, 2, 5, and 15 years post-diagnosis.
• Utilized multivariable propensity scoring to adjust for baseline differences and compare treatment outcomes.

Main Results:

• Prostatectomy patients had higher rates of urinary incontinence and erectile dysfunction at 2 and 5 years, but differences were not significant at 15 years.
• Prostatectomy patients reported less bowel urgency at 2 and 5 years, with no significant difference at 15 years.
• Despite initial differences, no significant long-term functional outcome disparities were observed between the two treatment groups at 15 years.

Conclusions:

• Radical prostatectomy and external-beam radiation therapy yield comparable disease-specific functional outcomes at 15 years for localized prostate cancer.
• Men treated for localized prostate cancer experience common declines in urinary, bowel, and sexual function over 15 years, irrespective of treatment modality.