Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer()

There is a paucity of knowledge of long-term urinary morbidity in patients treated for prostate cancer (PCa) with radical prostatectomy (RP) and salvage radiotherapy (SRT). Improved long-term survival calls for heightened awareness of late effects from radiotherapy after RP. The purpose of this study was to assess late urinary morbidity and its potential impact on quality of life (QoL) in patients treated with RP plus SRT compared with patients treated with RP alone.

Long-term morbidity and QoL were evaluated using a cross-sectional design with validated questionnaires in urinary morbidity [Danish Prostatic Symptom Score (DAN-PSS)] and QoL [European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)]. Included were a total of 227 patients treated with SRT and 192 treated with RP in the periods 2006-2010 and 2005-2007, respectively.

Weak stream, straining, frequency and nocturia were significantly more prevalent in patients treated with RP + SRT than in patients treated with RP alone. Patients treated with RP + SRT generally suffered from more severe urinary symptoms. The QoL scores of the two treatment groups were not statistically significantly different, but a high level of urinary morbidity was significantly related to decreased QoL (p = 0.000).

Patients treated with SRT have a higher rate of urinary morbidity than do patients treated with RP alone. Severe urinary morbidity was significantly related to decreased QoL, but did not differ between the two treatment groups.

Scandinavian journal of urology. 2017 Jul 27 [Epub ahead of print]

Maria Ervandian, Morten Høyer, Stine Elleberg Petersen, Lisa Sengeløv, Steinbjørn Hansen, Mette Moe Kempel, Peter Meidahl Petersen, Michael Borre

a Department of Urology , Aarhus University Hospital , Aarhus N , Denmark., b Danish Center for Particle Therapy , Aarhus University Hospital , Aarhus C , Denmark., c Department of Oncology , Herlev Hospital , Herlev , Denmark., d Department of Oncology , Odense University Hospital , Odense C , Denmark., e Department of Oncology , Aalborg University Hospital , Aalborg , Denmark., f Department of Oncology , Rigshospitalet , København Ø , Denmark.