Patient-reported outcomes after surgery or radiotherapy for localised prostate cancer: a retrospective study.

To compare the intermediate-term outcomes and patient-reported outcomes (PRO) of robot-assisted laparoscopic prostatectomy (RALP) and radical external beam radiotherapy (RT) in Chinese patients with localised prostate cancer.

This was a retrospective study performed in patients with localised prostate cancer diagnosed between 2010 and 2011 and treated with either RALP or RT. Information about baseline patient and disease characteristics, post-treatment complications, and latest disease status was retrospectively collected from hospital notes. For assessment of patient-reported outcomes, the Chinese version of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire was completed by the patients.

Ninety three patients aged 58 to 84 years were recruited. Thirty patients were treated by RALP (32.3%), whereas 63 received RT (67.7%). The RALP group had significantly lower baseline prostate-specific antigen levels than the RT group (P<0.001). More patients who underwent RALP reported urinary incontinence (70.0% vs 3.2%, P<0.001), whereas more patients who underwent RT reported other voiding symptoms (87.3% vs 50.0%, P<0.001) and perirectal bleeding (36.5% vs 0%, P<0.001) during follow-up. Of the 85 patients who were still alive at the time of the study, 52 (61.2%) returned completed questionnaires. Patients who underwent RALP had poorer median (interquartile range) EPIC urinary summary scores than patients who underwent RT [81.5 (18.3) vs 88.9 (17.9), P=0.016]. Urinary function [75.9 (20.4) vs 93.6 (16.2), P<0.001] and incontinence [60.5 (31.8) vs 91.8 (14.5), P<0.001] were also significantly worse in the RALP group. The bowel and sexual domain scores were similar between the two groups.

We found that RALP and RT were associated with different patterns of complications and patient-reported outcomes. Urinary incontinence was much more prevalent in the patients treated surgically. This may significantly affect patients' quality of life.

Hong Kong medical journal = Xianggang yi xue za zhi. 2020 Apr 02 [Epub ahead of print]

C F Ng, K Y Kong, C Y Li, J K T Li, N Y Li, B P K Ng, S C H Leung, C Y L Hong, C H Yee, J Y C Teoh

SH Ho Urology Centre, Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong.

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