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Title: Relief of urinary symptom burden after primary prostate cancer treatment
Author: Chang, Peter
Regan, Meredith M.
Ferrer, Montserrat
Guedea Edo, Ferran
Patil, Dattatraya
Wei, John T.
Hembroff, Larry A.
Jeff M. Michalski
Saigal, Chris S.
Litwin, Mark S.
Hamstra, Daniel A.
Kaplan, Irving D.
Ciezki, Jay P.
Klein, Eric A.
Kibel, Adam S.
Sandler, Howard M.
Dunn, Rodney L.
Crociani, Catrina M.
Sanda, Martin G.
PROST-QA Consortium
Keywords: Càncer de pròstata
Qualitat de vida
Avaluació de resultats (Assistència mèdica)
Cura dels malalts
Aparell urinari
Prostate cancer
Quality of life
Outcome assessment (Medical care)
Care of the sick
Urinary organs
Issue Date: 2-Sep-2016
Publisher: Elsevier B.V.
Abstract: Purpose: Harms of prostate cancer treatment on urinary health related quality of life have been thoroughly studied. In this study we evaluated not only the harms but also the potential benefits of prostate cancer treatment in relieving the pretreatment urinary symptom burden. Materials and Methods: In American (1,021) and Spanish (539) multicenter prospective cohorts of men with localized prostate cancer we evaluated the effects of radical prostatectomy, external radiotherapy or brachytherapy in relieving pretreatment urinary symptoms and in inducing urinary symptoms de novo, measured by changes in urinary medication use and patient reported urinary bother. Results: Urinary symptom burden improved in 23% and worsened in 28% of subjects after prostate cancer treatment in the American cohort. Urinary medication use rates before treatment and 2 years after treatment were 15% and 6% with radical prostatectomy, 22% and 26% with external radiotherapy, and 19% and 46% with brachytherapy, respectively. Pretreatment urinary medication use (OR 1.4, 95% CI 1.0-2.0, p = 0.04) and pretreatment moderate lower urinary tract symptoms (OR 2.8, 95% CI 2.2-3.6) predicted prostate cancer treatment associated relief of baseline urinary symptom burden. Subjects with pretreatment lower urinary tract symptoms who underwent radical prostatectomy experienced the greatest relief of pretreatment symptoms (OR 4.3, 95% CI 3.0-6.1), despite the development of deleterious de novo urinary incontinence in some men. The magnitude of pretreatment urinary symptom burden and beneficial effect of cancer treatment on those symptoms were verified in the Spanish cohort. Conclusions: Men with pretreatment lower urinary tract symptoms may experience benefit rather than harm in overall urinary outcome from primary prostate cancer treatment. Practitioners should consider the full spectrum of urinary symptom burden evident before prostate cancer treatment in treatment decisions.
Note: Versió postprint del document publicat a:
It is part of: Journal of Urology, 2016, vol. 197, num. 2, p. 376-384
Related resource:
ISSN: 0022-5347
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

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