QoL after RP, radiation therapy similar 15 years post-diagnosis

Over time, surgery and external beam radiation therapy led to similar long-term quality of life outcomes for patients with localized prostate cancer, according to 15-year follow-up data in more than 1,600 men.

Men who underwent radical prostatectomy reported more urine leakage, and radiation therapy was associated with more bowel problems. However, the degree to which men were bothered by the problems was similar with either type of definitive therapy.Otherwise, differences in other outcomes observed at 2 and 5 years tended to disappear by 15 years.

"Any differences between radiation therapy and surgery for localized prostate cancer become attenuated at 15 years," said first author Matthew Resnick, MD, of Vanderbilt University, Nashville, TN, working with David F. Penson, MD, MPH, and co-authors. "The data also show that, regardless of the time since treatment, there are still declines in virtually every functional domain that we evaluate in prostate cancer patients."

The findings came from an analysis of the Prostate Cancer Outcomes Study, which involved a cohort of 3,718 men with newly diagnosed prostate cancer in 1994 and 1995. Dr. Resnick reported 15-year outcomes for a subgroup of 1,655 men who were ages 55 to 74 at diagnosis.

At 15 years, 8.5% of the men who underwent radical prostatectomy reported no control over urine leakage or frequent leakage, as compared with 2.6% of the radiation therapy group. Nonetheless, the difference did not achieve statistical significance. The surgery group more often reported use of absorbent pads, but the degree of bother associated with pad use was similar among men treated with either modality.

The surgery group reported more problems with erectile dysfunction after 5 years compared with the radiation therapy group (OR: 1.96, 95% CI: 1.05-3.63). However, the difference was no longer statistically significant after 15 years of follow-up (OR: 2.63, 95% CI: 0.82-8.3). Moreover, the men reported a similar degree of bother related to sexual dysfunction at both 5 and 15 years, Dr. Resnick said.

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