Abstract
Purpose We evaluated whether preoperative erectile function is associated with pathologic features in the patients who underwent radical prostatectomy (RP).Materials and Methods We reviewed medical records of 1,743 men who underwent RP from November 2003 through May 2012. Of these, 50 patients who had prior hormone therapy and 272 patients who had lacking data of International Index of Erectile Function-5 (IIEF-5) were excluded. Men whose IIEF-5 was in the lower 25 percentile were assigned as Low Erectile Function group and the others were assigned as Control group. We compared pathologic features using univariable and multivariable logistic regression analysis between two groups.Results A total of 1,421 patients were included in the analysis. Patients’ age was 65.8 ± 6.7 years and prostate-specific antigen (PSA) was 12.8±16.1 ng/mL. Median and low 25 percentile of IIEF-5 were 14 and 8, respectively. Low Erectile Function group (IIEF-5<8) had higher risk to have high Gleason score (≥7(4+3), odds ratio (OR) 1.642, p<0.001) and large tumor volume (≥5 mL, OR 1.292, p=0.042). Even after adjusting age, year of surgery, body mass index, Charlson comorbidity index, PSA, clinical stage and biopsy Gleason score, Low Erectile Function group still had higher risk of high Gleason score (OR 1.910, p<0.001) and large tumor volume (OR 1.390, p=0.04) by multivariable logistic regressions.Conclusions Lower erectile function before RP was associated with higher Gleason’s score and larger tumor volume in final pathology. Thus, erectile function could be a surrogate barometer for prostate cancer aggressiveness.
Highlights
Prostate cancer (PC) is the second common cancer diagnosed and represents the sixth leading cause of death in male cancer patients worldwide [1]
Men whose Index of Erectile Function-5 (IIEF-5) was in the lower 25th percentile were assigned to the Low Erectile Function (LEF) group, and the others were assigned to the Control group
The basic characteristics of the 1,421 patients stratified by erectile function are presented in Table-1
Summary
Prostate cancer (PC) is the second common cancer diagnosed and represents the sixth leading cause of death in male cancer patients worldwide [1]. PC incidence rates increase in most countries except in a few high-income regions. Any kind of radical prostatectomy (RP) is the most commonly used treatment modality for localized PC. There is concern about adverse pathologic outcome after RP because of heterogeneous nature of PC. With proper estimation of final pathology, some patients can choose active surveillance or radiation therapy instead of RP [2]. Some patients can expect adjuvant or salvage treatment after RP [3]
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