You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20111535 PERSONALIZED PREDICTION OF ERECTION RECOVERY AFTER PRIMARY PROSTATE CANCER TREATMENT: VALIDATION IN THE COMMUNITY-BASED CAPSURE COHORT OF A PREDICTIVE MODEL DEVELOPED IN PROSTQA Mehrdad Alemozaffar, Martin Sanda, Natalia Sadetsky, Meredith Regan, Peter Carroll, and Matt Cooperberg Mehrdad AlemozaffarMehrdad Alemozaffar Boston, MA More articles by this author , Martin SandaMartin Sanda Boston, MA More articles by this author , Natalia SadetskyNatalia Sadetsky San Francisco, CA More articles by this author , Meredith ReganMeredith Regan Boston, MA More articles by this author , Peter CarrollPeter Carroll San Francisco, CA More articles by this author , and Matt CooperbergMatt Cooperberg San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1530AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prospects for erectile dysfunction (ED) due to prostate cancer (PCa) treatment are a key focus for many patients in treatment decision-making. However, tools to enable predicting ED based on patient baseline sexual function (SF) and other patient or treatment factors are sparse and no such models have been validated in a community-based setting. We sought to develop and validate such a predictive model. METHODS The PROSTQA academic-center based cohort (NEJM 358: 1250–61, 2008) was interrogated to create models using pre-treatment patient characteristics and treatment details to predict probability of ED (as defined by patient-reported erections firm enough for intercourse in response to the sexual domain component of the validated EPIC and UCLA-PCI HRQOL instruments) 2 years following prostatectomy (RP), external-beam radiation therapy (XRT), or brachytherapy (BT) for localized prostate cancer (N=1027). Performance of these predictive models in the community setting was evaluated, by calibrating model-predicted probability vs. observed ED at 2 years among CaPSURE participants who had completed SF evaluations before and after PCa treatment (N=1648). RESULTS Baseline factors comprising the model to predict ED 2 years after treatment (based on the PROSTQA cohort) included pretreatment SF (as measured by EPIC-SF score), age, PSA, and surgeon intent to use nerve-sparing, or plan for hormonal neoadjuvant with XRT or BT (p< 0.05 for each). The PROSTQA models performed well in predicting ED at 2-years following treatment with AUC's of 0.76, 0.81, and 0.89 for men undergoing RP, XRT, BT, respectively. Calibration showed that predicted rates of ED based on the PROSTQA-derived models accurately corresponded to the observed outcome in the CaPSURE cohort across a broad range of predicted probabilities (Table 1). Calibration of PROSTQA models in CaPSURE cohort: Comparison of Model-Predicted Probabilities of Functional Erections to Observed Proportions of Men Reporting Functional Erections Range for quintiles of PROSTQA-estimated 2yr erectile recovery N Mean PROSTQA-estimated Observed proportion 2yr erectile recovery in CaPSURE Treatment Type Prostatectomy 1st [0.001-0.03] 212 0.01 0.04 2nd [0.03-0.12] 212 0.07 0.08 3rd [0.12-0.25] 208 0.19 0.20 4th [0.25-0.40] 213 0.32 0.35 5th [0.40-0.75] 213 0.52 0.47 All 1058 0.22 0.23 External Radiotherapy 1st [0.005-0.01] 48 0.01 0.04 2nd [0.01-0.03] 52 0.02 0.00 3rd [0.03-0.09] 44 0.05 0.02 4th [0.09-0.25] 48 0.15 0.13 5th [0.25-0.79] 48 0.42 0.54 All 240 0.13 0.15 Brachytherapy 1st [0.0005-0.006] 70 0.003 0.01 2nd [0.01-0.04] 70 0.02 0.06 3rd [0.04-0.15] 70 0.08 0.16 4th [0.15-0.46] 70 0.29 0.36 5th [0.47-0.95] 70 0.68 0.79 All 350 0.22 0.27 CONCLUSIONS Validation in a community-based cohort of models to predict ED following PCa treatment based on pretreatment EPIC or UCLA-PCI sexual function score, age, PSA, and treatment details demonstrates that these models are generalizable. PROSTQA predictive models may be used to individualize patient outcome expectations by these pretreatment factors in the community setting. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e616-e617 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mehrdad Alemozaffar Boston, MA More articles by this author Martin Sanda Boston, MA More articles by this author Natalia Sadetsky San Francisco, CA More articles by this author Meredith Regan Boston, MA More articles by this author Peter Carroll San Francisco, CA More articles by this author Matt Cooperberg San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...