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293 Secondary radiotherapy after radical prostatectomy does not compromise urinary continence
293
Secondary radiotherapy after radical prostatectomy does not compromise urinary continence Eur Urol Suppl 2013;12;e293
Adam M.1, Wenzel P.1, Lanwehr D.1, Graefen M.1, Michl U.1, Faried A.2, Huland H.1, Schlomm T.1, Tennstedt P.1, Becker A.1, Schwarz R.2 1
Martini-Clinic, Martini-Clinic, Hamburg, Germany, 2University Hospital Hamburg-Eppendorf, Dept. of Therapeutic
Radiology, Hamburg, Germany INTRODUCTION & OBJECTIVES: The clinical value of adjuvant (aRT) or salvage radiation (sRT) for patient treated with radical prostatectomy (RP) is currently controversially debated. In this study, we assessed the impact of aRT and sRT on long-term urinary continence. MATERIAL & METHODS: Overall, 7884 patients with complete long-term urinary continence data who underwent RP in our center between 1992 and 2012 were analyzed. aRT was performed in 225 (2.9%) patients within the first 6 month after RP (median time 3.6 months), and sRT in 417 (5.3%) patients with proved biochemical relapse (median time 15.9 months), respectively. Continence rates were assessed annually the first 3 years after RP using a selfadministrated questionnaire. Continence was defined as the use of no pads and no leakage of urine. Incontinence was categorized by the number of used pads. The impact of additional radiation therapy on continence results was analyzed by logistic regression analyses and the chi2-likelyhood test . RESULTS: In multivariate logistic regression analysis, including age, prostate volume, extend of nerve-sparing, year of surgery, and secondary RT, the risk of incontinence was not statistically significantly increased for patients who received secondary RT compared to patients without RT (OR = 1.2, p = 0.20), whereas all other variables significantly correlated with urinary incontinence (p<0.0001, each). The lacking correlation of RT and continence remained in a second logistic regression model, adjusted for tumor features (pT, pN, Gleason, PSA, margin-status), and secondary RT (OR = 1.2, p = 0.10). In addition, no negative impact of secondary RT was observed in a subset of 97 patients with available continence data before and at least 6 month after RT (p<0.0001). CONCLUSIONS: Secondary radiation therapy does not negatively affect urinary continence results of radical prostatectomy.
Secondary radiotherapy after radical prostatectomy does not compromise urinary continence Eur Urol Suppl 2013;12;e293
Adam M.1, Wenzel P.1, Lanwehr D.1, Graefen M.1, Michl U.1, Faried A.2, Huland H.1, Schlomm T.1, Tennstedt P.1, Becker A.1, Schwarz R.2 1
Martini-Clinic, Martini-Clinic, Hamburg, Germany, 2University Hospital Hamburg-Eppendorf, Dept. of Therapeutic
Radiology, Hamburg, Germany INTRODUCTION & OBJECTIVES: The clinical value of adjuvant (aRT) or salvage radiation (sRT) for patient treated with radical prostatectomy (RP) is currently controversially debated. In this study, we assessed the impact of aRT and sRT on long-term urinary continence. MATERIAL & METHODS: Overall, 7884 patients with complete long-term urinary continence data who underwent RP in our center between 1992 and 2012 were analyzed. aRT was performed in 225 (2.9%) patients within the first 6 month after RP (median time 3.6 months), and sRT in 417 (5.3%) patients with proved biochemical relapse (median time 15.9 months), respectively. Continence rates were assessed annually the first 3 years after RP using a selfadministrated questionnaire. Continence was defined as the use of no pads and no leakage of urine. Incontinence was categorized by the number of used pads. The impact of additional radiation therapy on continence results was analyzed by logistic regression analyses and the chi2-likelyhood test . RESULTS: In multivariate logistic regression analysis, including age, prostate volume, extend of nerve-sparing, year of surgery, and secondary RT, the risk of incontinence was not statistically significantly increased for patients who received secondary RT compared to patients without RT (OR = 1.2, p = 0.20), whereas all other variables significantly correlated with urinary incontinence (p<0.0001, each). The lacking correlation of RT and continence remained in a second logistic regression model, adjusted for tumor features (pT, pN, Gleason, PSA, margin-status), and secondary RT (OR = 1.2, p = 0.10). In addition, no negative impact of secondary RT was observed in a subset of 97 patients with available continence data before and at least 6 month after RT (p<0.0001). CONCLUSIONS: Secondary radiation therapy does not negatively affect urinary continence results of radical prostatectomy.