Long-Term Outcomes Similar With Prostatectomy, Radiation
(HealthDay News) – At 15 years after diagnosis, disease-specific functional outcomes are not significantly different for men with localized cancer undergoing prostatectomy or radiotherapy, according to a study published in the Jan. 31 issue of the New England Journal of Medicine.
Matthew J. Resnick, MD, from Vanderbilt University in Nashville, TN, and colleagues analyzed data from a cohort of 1,655 men (aged 55–74 years when diagnosed with localized prostate cancer) participating in the Prostate Cancer Outcomes Study. The men had undergone surgery (1,164 men) or radiotherapy (491 men) and their functional status was assessed at baseline and at two, five, and 15 years after diagnosis.
The researchers found that, at two and five years, patients undergoing prostatectomy were significantly more likely to have urinary incontinence than were those undergoing radiotherapy (odds ratio [OR], 6.22 and 5.10, respectively). At 15 years, there was no significant between-group difference in the odds of urinary incontinence. Similarly, at two years and five years, patients undergoing prostatectomy were significantly more likely to have erectile dysfunction (OR, 3.46 and 1.96, respectively), but at 15 years there was no significant between-group difference. At two and five years, patients undergoing prostatectomy were significantly less likely to have bowel urgency (OR, 0.39 and 0.47, respectively), with no significant between-group difference at 15 years.
"Whereas short- and intermediate-term data reveal differences in functional profiles among men undergoing prostatectomy and radiotherapy, at 15 years we observed no significant relative between-group differences," the authors write. "Considering the often long duration of survival after treatment for prostate cancer, these data may be used to counsel men considering treatment for localized disease."