MP9-11 LONG-TERM RISK OF UROLOGIC COMPLICATIONS FOLLOWING CERVICAL CANCER TREATMENT

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 2015MP9-11 LONG-TERM RISK OF UROLOGIC COMPLICATIONS FOLLOWING CERVICAL CANCER TREATMENT Robert Goldfarb, Yunhua Fan, Stephanie Jarosek, Haitao Chu, Beth Virnig, and Sean Elliott Robert GoldfarbRobert Goldfarb More articles by this author , Yunhua FanYunhua Fan More articles by this author , Stephanie JarosekStephanie Jarosek More articles by this author , Haitao ChuHaitao Chu More articles by this author , Beth VirnigBeth Virnig More articles by this author , and Sean ElliottSean Elliott More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.371AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urologic complications, or urinary adverse events (UAEs), are a well-known sequela of cervical cancer, either secondary to advanced disease or as an unintended consequence of treatment. Radiotherapy (RT) toxicity can take years to manifest. Because most studies lack long-term follow-up, the true incidence of UAEs is still unknown. Our objective was to compare the long-term risks of UAEs between surgery and/or radiation for cervical cancer treatment. METHODS From the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, we identified women ≥ 66 years old with non-metastatic cervical cancer treated with simple surgery (SS), radical hysterectomy (RH), external beam RT plus brachytherapy (EBRT+BT), or RT+surgery. Non-cancer controls were matched 3:1 to cases. Differences in demographic and cancer characteristics were balanced by propensity weighting. Grade 3–4 UAEs were identified by diagnosis codes plus treatment codes and used to calculate cumulative incidence and hazard ratios. RESULTS UAEs occurred in 272/1808 cases (17%) and 222/5424 (4%) controls; most (62%) were ureteral strictures. The risk of UAEs increased with advanced disease (FIGO 3–4), independent of treatment type. UAEs occurred in 30.7% after EBRT+BT, 25.2% after RT+surgery, and 15.8% after RH; however, after propensity weighting, the incidence varied little across treatment groups (Figure 1). In adjusted models, the UAE risk after RT+surgery was statistically higher than after EBRT+BT; whereas, EBRT+BT and RH were statistically not different from each other. CONCLUSIONS This study is the first to document the population-based incidence of late UAEs in a cohort of women treated for cervical cancer with each of the available therapeutic combinations: radiation, surgery and surgery plus radiation. We demonstrate that the rate of UAEs is significant, especially in women with advanced cancers. We show that although radiated women were more likely to develop UAEs, the events were more closely tied to their advanced cancer than to their type of treatment. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e106 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Goldfarb More articles by this author Yunhua Fan More articles by this author Stephanie Jarosek More articles by this author Haitao Chu More articles by this author Beth Virnig More articles by this author Sean Elliott More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...