Patient-Reported Outcome Measures and Decision Regret After Salvage Radical Prostatectomy for Recurrent Prostate...

Area of Science:

• Urology
• Oncology
• Patient-Reported Outcomes

Background:

• Radical prostatectomy (RP) is an option for recurrent prostate cancer (PCa) after initial local therapy.
• The impact of prior treatments like radiotherapy (RT) or focal therapy (FT) on outcomes after salvage RP is not fully understood.

Purpose of the Study:

• To compare patient-reported outcome measures (PROMs) after salvage RP (RT-sRP and FT-sRP) versus primary RP.
• To assess the effects of prior RT or FT on health-related quality of life (HRQOL) and functional status post-RP.

Main Methods:

• A retrospective analysis of 26,515 RP patients (2014-2024).
• Validated PROMs (SF-12, EPIC-26, Decision Regret Scale) were used to evaluate HRQOL and functional status.
• Comparison of outcomes between primary RP, RT-sRP, and FT-sRP groups.

Main Results:

• RT-sRP patients reported significantly lower sexual function pre-RP compared to primary RP patients.
• One year post-RP, RT-sRP patients had lower functional status in all EPIC-26 domains versus primary RP.
• FT-sRP patients showed no significant difference in functional status compared to primary RP patients post-RP.
• Urinary incontinence scores were notably lower in RT-sRP (46) and FT-sRP (86) groups compared to primary RP (92).

Conclusions:

• Prior focal therapy (FT) has a minimal impact on HRQOL and function after radical prostatectomy (RP).
• Salvage radical prostatectomy after radiotherapy (RT-sRP) results in diminished urinary continence and sexual function compared to primary RP.
• Despite functional differences, prior local therapies do not contraindicate RP as a treatment option for recurrent prostate cancer.