MP27-03 DELAYING POST-OPERATIVE RADIATION THERAPY AFTER RADICAL PROSTATECTOMY IS ASSOCIATED WITH INCREASED FUNCTIONAL OUTCOMES: RESULTS FROM A LARGE SINGLE, REFERRAL CENTER SERIES

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You have accessJournal of UrologyCME1 May 2022MP27-03 DELAYING POST-OPERATIVE RADIATION THERAPY AFTER RADICAL PROSTATECTOMY IS ASSOCIATED WITH INCREASED FUNCTIONAL OUTCOMES: RESULTS FROM A LARGE SINGLE, REFERRAL CENTER SERIES Mario de Angelis, Elio Mazzone, Giorgio Gandaglia, Armando Stabile, Simone Scuderi, Francesco Barletta, Daniele Robesti, Luigi Nocera, Riccardo Leni, Vito Cucchiara, Marco Bandini, Emanuele Zaffuto, Nazareno Suardi, Andrea Necchi, Shahrokh F. Shariat, Francesco Montorsi, and Alberto Briganti Mario de AngelisMario de Angelis More articles by this author , Elio MazzoneElio Mazzone More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Armando StabileArmando Stabile More articles by this author , Simone ScuderiSimone Scuderi More articles by this author , Francesco BarlettaFrancesco Barletta More articles by this author , Daniele RobestiDaniele Robesti More articles by this author , Luigi NoceraLuigi Nocera More articles by this author , Riccardo LeniRiccardo Leni More articles by this author , Vito CucchiaraVito Cucchiara More articles by this author , Marco BandiniMarco Bandini More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Andrea NecchiAndrea Necchi More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002570.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Previous studies reported a detrimental effect of postoperative radiotherapy (RT) on functional outcomes in men treated with radical prostatectomy (RP). However, it is still unclear whether an optimal timing to mitigate such detrimental effect may exist. We explored the correlation between time from RP to RT on urinary continence (UC) and erectile function (EF) recovery. METHODS: We evaluated 3,867 men treated with RP between 2000 and 2018 at a single center and stratified for RT schedule (adjuvant RT [aRT], salvage RT [sRT], no RT). We examined EF and UC recovery rates at 3-year according to RT schedule, and according to time from RP to RT. UC recovery was defined as no pad use, while IIEF-EF score ≥22 defined EF recovery. Multivariable Cox regressions tested predictors of functional outcomes. Covariates consisted of type of approach (robotic vs open), nerve-sparing status, preoperative EF and UC status and year of surgery. The correlation between time from RP to RT and UC and EF recovery rates at 3-yr was explored using the Lowess function. RESULTS: Overall, 3032 (79%) received no postoperative RT, while 456 (12%) and 336 (9%) men underwent aRT or sRT. Median time to aRT and sRT were 4 and 24 months, respectively. The 3-year EF rates were 35%, 29% and 12% in men who received no RT, sRT and aRT (p <0.001). The 3-year UC rates were 84%, 60% and 70% in patients who received no RT, aRT and sRT (p <0.001). Cox regressions confirmed the negative impact of RT type on UC (aRT OR 0.51 p<0.001; sRT OR 0.71 p=0.009) and EF (aRT OR 0.27 p<0.001; sRT OR 0.58 p<0.001) recovery. At Lowess analysis, UC recovery was lower when men received postoperative RT within 18 months after RP, thereafter a substantial plateau of 3-yr UC was recorded. Similarly, the predicted 3-yr EF recovery rate progressively increased with delayed RT from RP, with rates ranging from 8 to 33% but without reaching a plateau (Fig. 1A-B). CONCLUSIONS: Postoperative RT was strongly associated with lower rates of UC and EF recovery. A variable correlation with time to RT was observed. Particularly, when postoperative RT is planned, UC recovery could be optimized if RT is administered later than 18 months from surgery. Conversely, for EF recovery, a linear correlation with time to RT was observed. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e450 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mario de Angelis More articles by this author Elio Mazzone More articles by this author Giorgio Gandaglia More articles by this author Armando Stabile More articles by this author Simone Scuderi More articles by this author Francesco Barletta More articles by this author Daniele Robesti More articles by this author Luigi Nocera More articles by this author Riccardo Leni More articles by this author Vito Cucchiara More articles by this author Marco Bandini More articles by this author Emanuele Zaffuto More articles by this author Nazareno Suardi More articles by this author Andrea Necchi More articles by this author Shahrokh F. Shariat More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF DownloadLoading ...