Login to Access Video or Poster Abstract: MP05-12
Sources of Funding: none

Introduction

Limited data is available on the influence of race on long-term potency preservation after prostate seed implant brachytherapy (PSI). We sought to identify if race and comorbidities effect long-term erectile function (EF) following PSI.

Methods

1,909 patients were identified from a prospectively managed database who underwent PSI for T1-T3 localized prostate cancer from 1990 to 2011. Median follow up time was 9.2 years (range 5-22). Patients were stratified by race and treatment type (PSI alone, PSI + EBRT, PSI + neoadjuvant hormone therapy (NHT) or PSI + EBRT and NHT. EF was assessed by SHIM questionnaire grouped into 4 categories (A: 0-7, B: 8-11. C:12-16 and D: 17-25) where C and D were considered potent. EF was recorded at initial, 5 year and last visit. NHT was given a median of 6 months. Last testosterone (T) levels were recorded a median 6 years after PSI. Pre- and post-treatment variables were compared by ANOVA, chi-square and multivariable regression. Potency preservation was estimated by Kaplan-Meier method with comparisons by log rank and Cox hazard rates (HR).

Results

There was no difference in SHIM scores between races pre-treatment. Caucasians (CC) were older than African Americans (AA) and Hispanics (H) (p=0.002). 42.6% of CC received implant alone compared to 32.5% of AA, and 28.9% of H (p<0.001). Combination therapy was more common in AA (40.8%) and H (41.3%) compared to 25.9% for CC (p<0.001). NHT was given to 59.8% of CC, 62.6% of AA and 61.2% of H men (p=0.001). EF was preserved overall in 82.5% and 40% at 5 and 10 years. Cox HR for EF included pre-SHIM score (HR 1.69, p<0.001), age (HR 1.04, p<0.001) and NHT use (HR 1.05, p=0.011). Total radiation dose, type of implant, race, T level and HD, diabetes, hypertension were not significant.

Conclusions

The presence of HD, pretreatment EF, age and prolonged use of NHT negatively impact EF. Other comorbidities and race do not appear to influence long-term preservation of potency.

Funding

none