PD47-01 THE EFFECT OF PROSTATE CANCER TREATMENT ON PATIENT REPORTED URINARY AND SEXUAL FUNCTION VARIES BY DISEASE SEVERITY: 3-YEAR RESULTS FROM THE CEASAR STUDY

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History III1 Apr 2017PD47-01 THE EFFECT OF PROSTATE CANCER TREATMENT ON PATIENT REPORTED URINARY AND SEXUAL FUNCTION VARIES BY DISEASE SEVERITY: 3-YEAR RESULTS FROM THE CEASAR STUDY Mark Tyson, JoAnn Alvarez, Tatsuki Koyama, Matthew Resnick, David Penson, and Daniel Barocas Mark TysonMark Tyson More articles by this author , JoAnn AlvarezJoAnn Alvarez More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , Matthew ResnickMatthew Resnick More articles by this author , David PensonDavid Penson More articles by this author , and Daniel BarocasDaniel Barocas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2361AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Disease severity may modulate the effects of prostate cancer treatment on patient-reported functional outcomes. The objective of this study is to determine how the effects of contemporary prostate cancer treatments on functional outcomes vary by disease risk. METHODS The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based, observational study which enrolled men with localized prostate cancer in 2011 and 2012. Patient-reported function was measured using the 26-item Expanded Prostate Index Composite (EPIC) at baseline, 6, 12, and 36 months after treatment. To identify differences in the effect of treatment on EPIC domain scores by disease risk, we fit a set of longitudinal models with interactions between disease risk and treatment type (radical prostatectomy [RP] or external beam radiotherapy [EBRT]) with adjustments for the following factors: time since treatment, pre-treatment function, age, race, comorbidity, educational attainment, insurance type, employment, marital status, physical function score, social support, depression score, participatory decision-making score, and study site. RESULTS Among the 2544 participants, 1144 (45%) had low-risk, 983 (39%) had intermediate-risk, and 417 (16%) had high-risk disease. Among low-risk patients, RP causes more severe decreases in sexual function compared to EBRT at 3 years (mean difference in EPIC score: -14.30 [95% CI: -18.56, -10.53]); however, among high-risk patients, this difference becomes both clinically and statistically insignificant (-4.46 [-9.79, 0.88]). With respect to incontinence, RP leads to even greater declines in function among high-risk patients compared to EBRT at 3 years (difference in treatment effects among low risk: -14.60 [-18.00, -11.19] and high risk: -19.25 [-23.87, -14.62]). No clinically significant interactions between treatment and risk were detected among the bowel, hormone, or urinary irritative domains. CONCLUSIONS These data suggest that the effect of treatment on urinary incontinence and sexual function vary by disease risk. Namely, high-risk patients report similar sexual function at 3 years regardless of treatment type but more drastic declines in urinary incontinence after surgery. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e896 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mark Tyson More articles by this author JoAnn Alvarez More articles by this author Tatsuki Koyama More articles by this author Matthew Resnick More articles by this author David Penson More articles by this author Daniel Barocas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...