Relief of urinary symptom burden after primary prostate cancer treatment.
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- dc.contributor.author Chang, Peterca
- dc.contributor.author Regan, Meredith M.ca
- dc.contributor.author Ferrer, Montserratca
- dc.contributor.author Guedea, Ferránca
- dc.contributor.author Patil, Dattatrayaca
- dc.contributor.author Wei, John T.ca
- dc.contributor.author Hembroff, Larry A.ca
- dc.contributor.author Michalski, Jeff M.ca
- dc.contributor.author Saigal, Chris S.ca
- dc.contributor.author Litwin, Mark S.ca
- dc.contributor.author Hamstra, Daniel A.ca
- dc.contributor.author Kaplan, Irving D.ca
- dc.contributor.author Ciezki, Jay P.ca
- dc.contributor.author Klein, Eric A.ca
- dc.contributor.author Kibel, Adam S.ca
- dc.contributor.author Sandler, Howard M.ca
- dc.contributor.author Dunn, Rodney L.ca
- dc.contributor.author Crociani, Catrina M.ca
- dc.contributor.author Sanda, Martin Georgeca
- dc.contributor.author PROST-QA Consortiumca
- dc.date.accessioned 2017-02-09T11:24:11Z
- dc.date.issued 2017
- dc.description.abstract PURPOSE: Harms of prostate cancer treatment on urinary health related quality of life have been thoroughly studied. In this study we evaluated not only the harms but also the potential benefits of prostate cancer treatment in relieving the pretreatment urinary symptom burden. MATERIALS AND METHODS: In American (1,021) and Spanish (539) multicenter prospective cohorts of men with localized prostate cancer we evaluated the effects of radical prostatectomy, external radiotherapy or brachytherapy in relieving pretreatment urinary symptoms and in inducing urinary symptoms de novo, measured by changes in urinary medication use and patient reported urinary bother. RESULTS: Urinary symptom burden improved in 23% and worsened in 28% of subjects after prostate cancer treatment in the American cohort. Urinary medication use rates before treatment and 2 years after treatment were 15% and 6% with radical prostatectomy, 22% and 26% with external radiotherapy, and 19% and 46% with brachytherapy, respectively. Pretreatment urinary medication use (OR 1.4, 95% CI 1.0-2.0, p = 0.04) and pretreatment moderate lower urinary tract symptoms (OR 2.8, 95% CI 2.2-3.6) predicted prostate cancer treatment associated relief of baseline urinary symptom burden. Subjects with pretreatment lower urinary tract symptoms who underwent radical prostatectomy experienced the greatest relief of pretreatment symptoms (OR 4.3, 95% CI 3.0-6.1), despite the development of deleterious de novo urinary incontinence in some men. The magnitude of pretreatment urinary symptom burden and beneficial effect of cancer treatment on those symptoms were verified in the Spanish cohort. CONCLUSIONS: Men with pretreatment lower urinary tract symptoms may experience benefit rather than harm in overall urinary outcome from primary prostate cancer treatment. Practitioners should consider the full spectrum of urinary symptom burden evident before prostate cancer treatment in treatment decisions.ca
- dc.description.sponsorship PROST-QA Consortium Funded by National Institutes of Health Grants R01 CA95662, RC1 CA146596, and RC1 EB011001. The Multicentric Spanish Group of Clinically Localized Prostate Cancer was supported by a grant from Instituto de Salud Carlos III FEDER: Fondo Europeo de Desarrollo Regional (PI13/00412). Dr. Chang supported by a Urology Care Foundation Research Scholar Award and the Martin and Diane Trust Career Development Chair in Surgery.
- dc.format.mimetype application/pdfca
- dc.identifier.citation Chang P, Regan MM, Ferrer M, Guedea F, Patil D, Wei JT, et al. Relief of urinary symptom burden after primary prostate cancer treatment. J Urol. 2017 Feb;197(2):376-384. doi: 10.1016/j.juro.2016.08.101ca
- dc.identifier.doi http://dx.doi.org/10.1016/j.juro.2016.08.101
- dc.identifier.issn 0022-5347
- dc.identifier.uri http://hdl.handle.net/10230/28096
- dc.language.iso engca
- dc.publisher Elsevierca
- dc.relation.ispartof The Journal of Urology. 2017 Feb;197(2):376-84
- dc.rights © Elsevier http://dx.doi.org/10.1016/j.juro.2016.08.101ca
- dc.rights.accessRights info:eu-repo/semantics/openAccessca
- dc.subject.other Pròstata -- Càncer -- Tractamentca
- dc.subject.other Aparell urinari -- Malaltiesca
- dc.title Relief of urinary symptom burden after primary prostate cancer treatment.ca
- dc.type info:eu-repo/semantics/articleca
- dc.type.version info:eu-repo/semantics/acceptedVersionca