1108 LONG TERM COMPLICATIONS IN MEN AFTER RADICAL PROSTATECTOMY WHO HAVE EARLY OR LATE RADIATION

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111108 LONG TERM COMPLICATIONS IN MEN AFTER RADICAL PROSTATECTOMY WHO HAVE EARLY OR LATE RADIATION Johan Gani, Harold Yim, Sidney B. Radomski, and Charles Catton Johan GaniJohan Gani Toronto, Canada More articles by this author , Harold YimHarold Yim Toronto, Canada More articles by this author , Sidney B. RadomskiSidney B. Radomski Toronto, Canada More articles by this author , and Charles CattonCharles Catton Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2624AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with prostate cancer who are treated with early radiation after radical prostatectomy (RP) may have increased risk of urinary incontinence, bladder neck contracture (BNC) or urethral stricture (US) as compared to those treated with late radiation. This is thought to be due to radiation damage on healing tissues postoperatively. We undertook to evaluate the complication rates of men treated with surgery followed by early or late external beam radiation (RT). METHODS Retrospective outcomes were determined up to 3 years post treatment for 652 patients who underwent a RP followed by early RT (<6months after surgery) or late RT (>6months after surgery) between Jan 2000 and Oct 2007. Urinary incontinence was defined as the presence of any leakage. BNC and US were diagnosed on cystoscopic findings. Fisher's T test was used to analyze the data. RESULTS 162 (24.8%) patients had early radiation and 490 (75.2%) had late radiation. Mean age at RP was 60.4 years (range 41–76 years). Mean time to early and late RT was 3.6 months (range 1–5 months) and 30.1 months (range 6–171 months) respectively. The median radiation dose was 66Gy (range 50–70Gy). Of the early RT patients, 88/162 (54.3%) were incontinent postoperatively. Of these, 42 (25.9%); 30 (18.5%) and 27 (16.7%) were incontinent at 1, 2 and 3 years post RT respectively. Of the late RT patients, 170/490 (34.7%) were incontinent postoperatively. Of these, 95 (19.4%); 82 (16.7%) and 72 (14.7%) were incontinent at 1, 2 and 3 years post RT respectively. BNC developed postoperatively in 27/652 (4%) patients, US in 10/652 (1.5%) and 1 patient developed both. At 3 years post RT, 23/27 BNC resolved, 1 persisted and 3 were status unknown. At 3 years post RT, 6/10 US had resolved and 4/10 were status unknown. Throughout the 3 years post RT, 16 new BNC occurred (12 resolved) and 5 new US occurred (3 resolved). There was no significant difference in rates of incontinence, BNC and US between early and late radiation at 3 years post RT. CONCLUSIONS Incontinence was frequently reported post-RP and this improved over time despite the use of post-operative RT. There was no significant difference between early and late RT at 3 years post radiation in terms of incontinence, bladder neck contractures and urethral strictures. This suggests that the timing of radiation does not alter the incidences of these complications after RP. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e445 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johan Gani Toronto, Canada More articles by this author Harold Yim Toronto, Canada More articles by this author Sidney B. Radomski Toronto, Canada More articles by this author Charles Catton Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...