Login to Access Video or Poster Abstract: MP93-10
Sources of Funding: none

Introduction

Given the various treatment options available to men diagnosed with prostate cancer, optimal urinary, sexual, and bowel function should be goals of care in addition to disease free survival. This study assesses factors including management decision for localized prostate cancer and their association with urinary, bowel, and sexual function at 2 years following definitive procedural treatment (radical prostatectomy (RP) or brachytherapy (BT)) or active surveillance (AS).

Methods

An institutional review of 572 patients who underwent definitive procedural treatment or AS and completed a validated Prostate Health Related Quality of Life Questionnaire at both the time of treatment selection and at 2 year follow-up. Urinary, sexual, and bowel function at 2 years were assessed by self-reported responses to 3 separate questions asking, "Overall, how big a problem has your urinary/sexual/bowel function been for you during the last 4 weeks?" Patient and disease characteristics, baseline urinary, sexual and bowel function, and management selection were analyzed on multivariable logistic regression models for 2 year function outcomes.

Results

The median age in this cohort was 62 years (IQR: 57-68) with 109 (19%) patients who elected BT, 102 (18%) participated in AS, and 361 (63%) received RP. On multivariable logistic regression for urine function at 2 years, BT vs. AS (HR: 5.4, p = 0.011) and RP vs. AS (HR: 4.0, p = 0.026) associated with worse urinary function. Presence of a partner was associated with better preservation of sexual function (HR: 0.4, p = 0.009), while RP vs. AS (HR: 2.2, p = 0.013) was associated with worse sexual function at 2 years. Significant baseline bowel bother associated with worse bowel function at 2 years (HR: 11.7, p <0.0001); however, type of management was not significantly associated with adverse bowel function.

Conclusions

The 2 year urinary, sexual and bowel functions among patients managed for localized prostate cancer are based on multiple patient characteristics in addition to the shared decision for BT, RP or AS. Additional studies should examine matched function outcomes among men managed for localized prostate cancer.

Funding

none