We aimed to investigate the predictive factor of erectile dysfunction (ED) in prostate cancer (PCa) patients who underwent low-dose permanent I(125) seed implant brachytherapy and to investigate if ED could represent a patient's reported outcome measures (PROMs) of efficacy of BT and indirectly associated with biochemical recurrence free survival (BRFS).
From 2000 to 2012, 176 consecutive patients with low-risk PCa underwent BT. ED was evaluated with the International Index of Erectile Function (IIEF-5). Cox regression analysis was performed to assess significant predictors of mild-to-severe ED and BRFS after BT, including covariates. The 10-year actuarial rate of ED was 66%. Subjects with severe ED had higher values of D90 (183. 0 versus 177. 0; p < 0. 05) and V100% (40. 1 versus 31. 4; p < 0. 05) compared with normal. At the multivariate logistic regression analysis, D90 (OR: 1. 10; p < 0. 05) was an independent predictor of ED. Multivariate Cox-regression analysis did not demonstrate significant association between erectile preservation and biochemical recurrence (BCR) after 10 years of follow up (HR: 2. 15; p = 0. 20), while D90 ≤ 180 Gy independently predicted BCR (HR: 4. 65; [95%CI: 1. 25-17. 34]; p < 0. 05). Erectile preservation should be addressed as valuable PROMs after permanent seed I(125) implant, but it is not associated with better BRFS.
The aging male : the official journal of the International Society for the Study of the Aging Male. 2015 Sep 16 [Epub ahead of print]
Giuseppe Morgia, Tommaso Castelli, Salvatore Privitera, Chaled Al-Nakib, Vincenzo Favilla, Francesco Marchese, Sebastiano Cimino, Giorgio Ivan Russo
a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy. , a Department of Urology , University of Catania , Catania , Italy.