Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 24, No 18S (June 20 Supplement), 2006: 4507
© 2006 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chen, R. C. Articles by Talcott, J. A. Search for Related Content PubMed Articles by Chen, R. C. Articles by Talcott, J. A.

Abstract

Long-term outcomes after local treatments for prostate cancer by functional categories: Late changes, different results

Massachusetts General Hospital, Boston, MA; Boston University School of Public Health, Boston, MA

4507

Background: Although patient-reported treatment outcomes have gained wide acceptance, numerical changes in validated instruments are difficult to interpret by patients and physicians. Using functional categories derived from numerical scales, we report 24- and 36-month outcomes after treatments for localized prostate cancer, presented by patients’ baseline (pre-treatment) functional status, to provide more useful prognostic information and to identify further changes in the third year after treatment. Methods: Using validated symptom indices, we prospectively measured sexual, urinary, and bowel functions of 438 men at baseline, and at fixed intervals post treatment. We translated numerical scores into functional categories: good (normal), intermediate, and poor (severe dysfunction). Results: Abnormal baseline function and surgery in men with normal function uniformly produced poor sexual function (table), and more external beam radiotherapy (EBRT) and brachytherapy (BT) patients deteriorated between 24 and 36 months. For those with normal urinary continence, NNSRP (non-nerve sparing radical prostatectomy) produced poor outcomes (26%) more frequently than NSRP (9%) at 24 months and 36 months, despite improvement in some NNSRP patients. Severe incontinence was rare after EBRT (1%) and BT (3%), though slightly more frequent in EBRT patients by 36 months. For patients with normal bowel function, EBRT and BT caused worse outcomes than RP; no change occurred after 24 months. Conclusions: Abnormal baseline sexual function and surgery produced uniformly poor sexual function outcomes and poor function increased significantly between 24 and 36 months after radiation therapy. Significant changes in functional category occurred despite unchanged average numerical scores, indicating that stable numerical indices may conceal significant functional changes.

No significant financial relationships to disclose.

Abstract presentation from the 2006 ASCO Annual Meeting