What is lost in an average? Identifying distinct post-radical prostatectomy functional recovery profiles

Area of Science:

• Urology
• Oncology
• Health Outcomes Research

Background:

• Radical prostatectomy (RP) is a common treatment for prostate cancer.
• Current patient-reported outcome (PRO) data often relies on statistical averages, which may not reflect individual recovery trajectories.
• Distinct recovery profiles can enhance shared decision-making processes.

Purpose of the Study:

• To identify and describe distinct patient-reported outcome (PRO) recovery profiles following radical prostatectomy (RP) using latent variable mixture modeling.
• To complement existing statistical averages with nuanced recovery patterns for improved shared decision-making.

Main Methods:

• Latent variable mixture modeling and hierarchical cluster analysis were applied to urinary incontinence (UI) and sexual function (SF) recovery scores.
• Data from 3956 patients who underwent RP and completed the Expanded Prostate Cancer Index Composite 12 months post-surgery were analyzed.
• Models were selected based on optimal performance metrics.

Main Results:

• Three distinct urinary incontinence (UI) recovery profiles were identified, with prevalences of 49%, 37%, and 14% (best to worst recovery).
• Four distinct sexual function (SF) recovery profiles were identified, with prevalences of 14%, 24%, 42%, and 20% (best to worst recovery).
• The two worst SF profiles showed similar function but differed in how bothersome the function was perceived.

Conclusions:

• Distinct urinary incontinence (UI) and sexual function (SF) recovery profiles following radical prostatectomy (RP) were identified.
• The prevalence of these distinct profiles was determined from a large patient registry.
• These findings can improve the interpretability of PRO data for clinical decision-making.