The investigators evaluated the complication rates of men treated with surgery followed by early or late external beam radiation (XRT). They analyzed retrospective outcomes up to 3 years post treatment for 652 patients who underwent a RP followed by early XRT (<6 months after surgery) or late XRT (>6months after surgery) between 2000 and 2007. Urinary incontinence was defined as the presence of any leakage. BNC and US were diagnosed on cystoscopic findings.
162 (24.8%) patients had early XRT and 490 (75.2%) had late XRT. Mean age at RP was 60.4 years. Mean time to early and late XRT was 3.6 months and 30.1 months, respectively. The median radiation dose was 66Gy. Of the early XRT patients, 88/162 (54.3%) were incontinent postoperatively. Of these 42 (25.9%), 30 (18.5%) and 27 (16.7%) were incontinent at 1, 2 and 3 years post XRT respectively. Of the late XRT patients, 170/490 (34.7%) were incontinent postoperatively. Of these, 95 (19.4%), 82 (16.7%) and 72 (14.7%) were incontinent at 1, 2 and 3 years post XRT respectively. BNC developed postoperatively in 27/652 (4%) patients, US in 10/652 (1.5%) and 1 patient developed both. At 3 years post XRT, 23/27 BNC resolved, 1 persisted and 3 were status unknown. At 3 years post XRT, 6/10 US had resolved and 4/10 had unknown status. Throughout the 3 years post XRT, 16 new BNC occurred (12 resolved) and 5 new US occurred (3 resolved). There was no significant difference in rates of incontinence, BNC and US between early and late radiation at 3 years post XRT.
Presented by Johan Gani, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.