The Effect of Prostatectomy Technique on Genitourinary Toxicity

Abstract

Recent clinical trials have examined the toxicity associated with various treatment modalities available for prostate cancer. None have examined genitourinary (GU) toxicity using CTCAE v4.02 among prostatectomy (RP) techniques. An IRB-approved inception cohort study was used to assess the association of GU toxicity by prostatectomy technique: open RP, pure laparoscopic (lap RP) RP, and robotic-assisted laparoscopic (robotic) RP. The primary end point was grade 3 or greater GU toxicity. The cumulative incidence method was used to calculate the rates of grade 3 or higher GU toxicity, and Gray’s test was used to compare the rates of toxicity among the three treatment modalities. There were 1308 patients in the study with a median follow-up of 55.6 months. The patients were segregated into the three cohorts as follows: 732 open RP, 103 lap RP, and 473 robotic RP. The cumulative incidence rates of the primary end point is shown in table 1. There was no significant difference among the three modalities (p = 0.6028). The most common toxicities were urinary obstruction (54.8 % of all toxicities) and urinary incontinence (33.3 % of all toxicities). Eighty-five percent of all toxicities were grade 3. Overall toxicities were mild and were not different among the three RP techniques.Abstract 2536TimeProstatectomy TypePure LaparoscopicRobotic-AssistedOpen1 YearNumber at Risk73359634Cumulative Incidence (%)6.83.56.895% CI (%)1.5-12.11.8-5.34.9-8.65 YearsNumber at Risk47106405Cumulative Incidence (%)9.211.313.895% CI (%)3.1-15.37.9-14.811.2-16.510 yearsNumber at Risk143206Cumulative Incidence (%)16.615.517.195% CI (%)6.5-26.28.1-22.914.0-20.2 Open table in a new tab