You have accessJournal of UrologyCME1 Apr 2023PD15-02 LONG-TERM HEALTH RELATED QUALITY OF LIFE IN PROSTATE CANCER PATIENTS REQUIRING RADIOTHERAPY AFTER RADICAL PROSTATECTOMY T. Anders Olsen, Sagar Patel, Dattatraya Patil, Louis Alperti, Joseph Smith, Christopher Saigal, Mark Litwin, Jim Hu, Matthew Cooperberg, Peter Carroll, Eric Klein, Jay Ciezki, Adam Kibel, Gerald Andriole, Jeff Michalski, Misop Han, Alan Partin, David Wood, Larry Hembroff, Daniel Spratt, John Wei, Howard Sandler, Daniel Hamstra, Louis Pisters, Deborah Kuban, Meredith Regan, Andrew Wagner, Irving Kaplan, Catrina Crociani, Martin Sanda, and Peter Chang T. Anders OlsenT. Anders Olsen More articles by this author , Sagar PatelSagar Patel More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Louis AlpertiLouis Alperti More articles by this author , Joseph SmithJoseph Smith More articles by this author , Christopher SaigalChristopher Saigal More articles by this author , Mark LitwinMark Litwin More articles by this author , Jim HuJim Hu More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Peter CarrollPeter Carroll More articles by this author , Eric KleinEric Klein More articles by this author , Jay CiezkiJay Ciezki More articles by this author , Adam KibelAdam Kibel More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , Jeff MichalskiJeff Michalski More articles by this author , Misop HanMisop Han More articles by this author , Alan PartinAlan Partin More articles by this author , David WoodDavid Wood More articles by this author , Larry HembroffLarry Hembroff More articles by this author , Daniel SprattDaniel Spratt More articles by this author , John WeiJohn Wei More articles by this author , Howard SandlerHoward Sandler More articles by this author , Daniel HamstraDaniel Hamstra More articles by this author , Louis PistersLouis Pisters More articles by this author , Deborah KubanDeborah Kuban More articles by this author , Meredith ReganMeredith Regan More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , Irving KaplanIrving Kaplan More articles by this author , Catrina CrocianiCatrina Crociani More articles by this author , Martin SandaMartin Sanda More articles by this author , and Peter ChangPeter Chang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003262.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The optimal timing of radiotherapy (XRT) after radical prostatectomy (RP) is controversial, and the impact of early versus late post-RP XRT on patient-reported health related quality of life (HRQOL) is unclear. METHODS: In our PROST-QA (2003-2006) and RP2 (2010-2014) consortium studies, 1203 men with localized prostate cancer were treated with RP; of those, 121 men received post-RP XRT. All subjects were prospectively enrolled and underwent longitudinal clinical follow-up and third-party HRQOL evaluation. The exposure of interest was receipt and timing of post-RP XRT, leading to three treatment groups: 1) RP only (n=1,082), 2) RP+early XRT (n=57), and 3) RP+late XRT (n=64). Early versus late XRT was defined as ≤12 months and >12 months post-RP, respectively. The primary outcome was HRQOL via the Expanded Prostate Cancer Index Composite (EPIC-26) sexual, urinary incontinence and urinary irritation/obstruction scores, measured at pre-treatment and annually thereafter. Treatment groups were compared using multivariable generalized estimating equations (GEE) models of change in longitudinal HRQOL domain scores. Urinary incontinence pad usage was also evaluated before and after post-RP XRT. RESULTS: Median follow-up for the entire cohort was 85.6 months (IQR 35.8-117.2). Compared to RP alone, subjects undergoing post-RP XRT had significantly worse longitudinal changes in sexual, urinary incontinence and urinary irritation/obstruction HRQOL (p-values: 0.03, 0.004, <0.001, respectively). We were unable to detect HRQOL differences between late and early XRT longitudinally, due possibly to the size of the XRT cohorts (n=121 total). Longitudinal differences between the three groups are demonstrated in Figure 1. Continued post-RP recovery for urinary control was noted after early XRT, as 49% of subjects were pad-free before XRT, and 70% were pad free at their next HRQOL evaluations. CONCLUSIONS: This prospective cohort study with long-term follow up confirms the detrimental impact of XRT on post-RP HRQOL. Distinguishing differences between late and early XRT after RP was not detectible, limited by the size of our post-RP XRT cohorts. Further study is needed to assess the differential impact of treatments and prostate cancer recurrence/progression on HRQOL. Source of Funding: NCT01325506: Effectiveness of Open and Robotic Prostatectomy (PROSTQA- RP2); 5RC1EB011001-02 Effectiveness of Robotic Compared to Standard Prostatectomy for Prostate Cancer © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e418 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information T. Anders Olsen More articles by this author Sagar Patel More articles by this author Dattatraya Patil More articles by this author Louis Alperti More articles by this author Joseph Smith More articles by this author Christopher Saigal More articles by this author Mark Litwin More articles by this author Jim Hu More articles by this author Matthew Cooperberg More articles by this author Peter Carroll More articles by this author Eric Klein More articles by this author Jay Ciezki More articles by this author Adam Kibel More articles by this author Gerald Andriole More articles by this author Jeff Michalski More articles by this author Misop Han More articles by this author Alan Partin More articles by this author David Wood More articles by this author Larry Hembroff More articles by this author Daniel Spratt More articles by this author John Wei More articles by this author Howard Sandler More articles by this author Daniel Hamstra More articles by this author Louis Pisters More articles by this author Deborah Kuban More articles by this author Meredith Regan More articles by this author Andrew Wagner More articles by this author Irving Kaplan More articles by this author Catrina Crociani More articles by this author Martin Sanda More articles by this author Peter Chang More articles by this author Expand All Advertisement PDF downloadLoading ...