Early Post-Operative Radiotherapy is Associated with Worse Functional Outcomes in Prostate Cancer Patients

The role of the time between radical prostatectomy (RP) and radiation therapy (RT) on postoperative functional outcomes is still unclear in surgically-managed prostate cancer (PCa) patients. We hypothesized that a shorter time interval between RP and RT might be associated with worse functional recovery rates after RP.

We retrospectively evaluated 2,190 patients treated with RP. Patients were stratified according to RT schedule (adjuvant RT, salvage RT, no RT). We examinated erectile function (EF) and urinary function (UC) recovery rates according to adjuvant RT (aRT), salvage RT (sRT) and no RT and according to time from surgery to RT. Cox regression analyses evaluated the impact of these predictors on functional outcomes.

Median follow-up was 48 months. The 3-year EF recovery rates were 35.0, 29.0 and 11.6% in patients who received no RT, sRT and aRT, respectively (p<0.001), and significantly differed according to the time to RT (11.7% vs. 34.7% for time to RT <1 year vs. ≥1 year, respectively; p<0.001). The 3-year UC recovery rates were 70.7, 59.0 and 42.2% in patients who received no RT, sRT and aRT, respectively (p<0.001), and differed according to the time to RT (43.5% vs. 62.7% for time to RT <1 year vs. ≥1 year, respectively; p<0.001). Cox regression analyses confirmed the negative impact of early RT on EF and UC recovery rates.

The time from RP to RT has an important role in EF and UC recovery. Delayed RT should be preferred to improve functional outcomes after surgery.

The Journal of urology. 2016 Sep 23 [Epub ahead of print]

Emanuele Zaffuto, Giorgio Gandaglia, Nicola Fossati, Paolo Dell'Oglio, Marco Moschini, Vito Cucchiara, Nazareno Suardi, Vincenzo Mirone, Marco Bandini, Shahrokh F Shariat, Pierre I Karakiewicz, Francesco Montorsi, Alberto Briganti

Division of Oncology/Unit of Urology; Urological Research Institute; IRCCS Ospedale San Raffaele; Milan, Italy; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada., Division of Oncology/Unit of Urology; Urological Research Institute; IRCCS Ospedale San Raffaele; Milan, Italy., Urology Department, University of Naples Federico II, Naples, Italy., Department of Urology, Medical University of Vienna, Vienna, Austria., Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada., Division of Oncology/Unit of Urology; Urological Research Institute; IRCCS Ospedale San Raffaele; Milan, Italy. Electronic address: .