Abstract: PD18-03
Sources of Funding: NIH (MGS, CC), Urology Care Foundation Scholar grant (AM, PC), and Movember True North (AM, DP, MGS)._x000D_

Introduction

While the effects of radical prostatectomy (RP) on urinary and sexual health related quality of life (HRQOL) have been well-studied, how long-term HRQOL may be further modified by adjuvant or salvage radiotherapy (XRT) after RP has not been fully characterized.

Methods

We evaluated RP subjects from the PROSTQA (2003-2006) and RP2 (2010-2013) Consortiums, two separate multicenter prospective cohorts of men who underwent treatment for localized prostate cancer in US academic medical centers (Sanda et al. NEJM 2008). Subjects completed EPIC-26 at pre-treatment baseline and annually thereafter by third party telephone interview. We used the unpaired t-test to compared long-term changes in the sexual, urinary incontinence, and urinary irritation domains between men who 1) did not undergo adjuvant or salvage XRT (RP-only), 2) received adjuvant XRT: within 1 year of RP, and 3) received salvage XRT: >1 year post-RP.

Results

Of the 1131 men who underwent RP, 1097 had RP-only, 57 had adjuvant XRT, and 50 had salvage XRT. Mean follow up was 49.7 months (range 0-122.9). Subjects who underwent post-RP XRT were significantly more likely to have a higher baseline PSA, Gleason 8-10 disease, T2 disease (vs T1) than those who underwent RP only. Patients receiving post-RP XRT had worse outcomes in sexual, urinary incontinence and urinary irritation domains (p<0.05 during longitudinal follow up, fig 1). However, further stratification of men receiving post-RP XRT into those receiving salvage XRT contrasted to adjuvant XRT showed that adjuvant XRT had worse sexual HRQOL than RP-only in the first 2 years, whereas salvage XRT had worse sexual HRQOL than RP-only throughout 9 years of follow up (p<0.05) . Other HRQOL domains did not show this differential.

Conclusions

Adjuvant and salvage XRT negatively affect HRQOL in patients treated with RP. These deleterious effects are more clearly observed in subjects undergoing salvage XRT. As follow-up for the RP2 consortium continues to mature, further study is needed to determine whether these findings are related to treatment effects or baseline differences between subjects.

Funding

NIH (MGS, CC), Urology Care Foundation Scholar grant (AM, PC), and Movember True North (AM, DP, MGS)._x000D_