You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality of Life1 Apr 2015MP27-11 DISTINCT SIDE EFFECT PROFILES AFTER CONTEMPORARY TREATMENT OF LOCALIZED PROSTATE CANCER Karen Hoffman, JoAnn Alvarez, Daniel Barocas, Tatsuki Koyama, Alicia Morgans, Sharon Phillips, Matthew Resnick, David Penson, and CEASAR Investigators Karen HoffmanKaren Hoffman More articles by this author , JoAnn AlvarezJoAnn Alvarez More articles by this author , Daniel BarocasDaniel Barocas More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , Alicia MorgansAlicia Morgans More articles by this author , Sharon PhillipsSharon Phillips More articles by this author , Matthew ResnickMatthew Resnick More articles by this author , David PensonDavid Penson More articles by this author , and CEASAR Investigators More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1173AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There have been significant advances in surgical and radiotherapy techniques for prostate cancer treatment. We evaluated urinary, bowel, and sexual function after contemporary management of localized prostate cancer. METHODS The Comparative Effectiveness Analyses of Surgery and Radiation (CEASAR) study enrolled men diagnosed with T1-T2 N0, PSA < 50 prostate cancer in 2011 or 2012. Patient-reported function was assessed at baseline and 6 and 12 months after diagnosis using the 26-item Expanded Prostate Index Composite. Functional domain scores range from 0 (worst) to 100 (best). Regression models of mean function comparing surgery (RP n=1456), external beam radiation (EBRT n = 578), and active surveillance (AS n=436) were fit adjusting for treatment propensity, baseline function, health status, and patient and tumor characteristics. RESULTS Most men underwent robotic RP (68% of RP) or IMRT (83% of EBRT). Figures illustrate unadjusted changes in mean function over time. Compared to men managed with AS, men treated with RP reported worse sexual function (adjusted effect size -29 [95%CI -33, -26] p<0.001) and urinary incontinence (-19 [-21, -16] p<0.001) at 12 months. Compared to men managed with AS, men treated with EBRT reported slightly lower sexual (-7 [-11, -3] p<0.001) and bowel (-3 [-5, -1] p<0.001) function but similar urinary function at 12 months. Men treated with EBRT had better sexual function (27 [23, 30] p<0.001) and incontinence (28 [25, 31] p<0.001) than men treated with RP by six months. These differences attenuated but remained at 12 months (23 [19, 26] sexual; 20 [18, 23] incontinence). Men managed with AS reported no functional decline (figures). CONCLUSIONS Contemporary management strategies have side effect profiles that differ from older techniques. Modern EBRT has minimal impact on bowel and urinary function and less impact on sexual function than RP through 1 year. These distinct side effect profiles should be discussed when counseling men on the appropriate treatment of their localized prostate cancer. Comparison of patient-reported function 12 months after treatment adjusting for treatment propensity, baseline function, health status, and patient and tumor characteristics. Comparison Domain Effect 95% CI p-value EBRT vs. RP Sexual function 22.5 19.1, 25.9 <0.001 Urinary incontinence 20.3 17.5, 23.1 <0.001 Urinary irritative 1.7 -3.5, 0.1 0.061 Bowel function -4.3 -5.9, -2.7 <0.001 Estimated mean difference from multiple regression models. P value less than 0.01 was considered significant. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e306-e307 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Karen Hoffman More articles by this author JoAnn Alvarez More articles by this author Daniel Barocas More articles by this author Tatsuki Koyama More articles by this author Alicia Morgans More articles by this author Sharon Phillips More articles by this author Matthew Resnick More articles by this author David Penson More articles by this author CEASAR Investigators More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...