INTRODUCTION: Successful treatment of locally confined prostate cancer is defined by post-operative cancer control, continence, and potency.
The Expanded Prostate cancer Index Composite (EPIC) is a validated instrument developed specifically for use with prostate cancer survivors with the ability to assess both urinary (EPIC-UIN) and sexual (EPIC-S) function. We evaluated the utility of urinary and sexual function measured by EPIC at baseline and 3 month follow-up after prostatectomy for prediction of functional outcomes at 1 year post-operatively.
METHODS: We retrospectively reviewed a prospectively maintained, IRB-approved database for prostatectomy patients from 2000-2009. EPIC scores were acquired pre-operatively and at 3 and 12 month follow-ups. Likelihood of sexual and urinary recovery at 12-months based on 3-month EPIC-UIN and EPIC-S scores was calculated.
RESULTS: Patients were treated with open (N=226) or robotic (N= 235) surgery. Patients with complete EPIC-UIN questionnaires (N = 437) had worsened (2.7%), improved (47.8%), and stable (49.4%) urinary function and those with complete EPIC-S questionnaires (N= 436) had worsened (3.9%), improved (36.9%) and stable (59.2%), respectively, at 12-months compared to 3-month scores. Return to baseline was predicted by 3-month EPIC-UIN scores ≥ 50 (OR 7.76, p < 0.0001) and EPIC-S scores ≥ 45 (OR 3.64, p < 0.0001). Pearson correlation coefficients between 3 and 12-month EPIC-UIN and EPIC-S scores were 0.65 and 0.73, respectively.
CONCLUSIONS: EPIC-UIN and EPIC-S scores at 3-months are useful for predicting functional outcomes at 12 months. Health-related quality of life instruments should be applied in the early post-operative period to aid in counseling patients regarding recovery.
Ellison JS, He C, Wood DP. Are you the author?
Reference: J Urol. 2013 Apr 19. pii: S0022-5347(13)04095-0.