1
|
Kowalski C, Sibert NT, Hammerer P, Wesselmann S, Feick G, Carl EG, Klotz T, Apel H, Dieng S, Nyarangi-Dix J, Knoll T, Reike MJ, Duwe G, Bartolf E, Steiner T, Borowitz R, Lümmen G, Seitz AK, Pfitzenmaier J, Aziz A, Brock M, Berger FP, Kaftan BT, Grube C, Häfner T, Hamza A, Schmelz H, Haas J, Lenart S, Lafita A, Sippel C, Winter A, Kedia G, Hadaschik B, Varga Z, Buse S, Richter M, Distler F, Simon J, Wiegel T, Baltes S, Janitzky A, Sommer JP, Hijazi S, Fülkell P, Harke NN, Bolenz C, Khalil C, Breidenbach C, Tennstedt P, Burchardt M. [Urinary incontinence after radical prostatectomy for prostate cancer-data from 17,149 patients from 125 certified centers]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:67-74. [PMID: 37747493 DOI: 10.1007/s00120-023-02197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND In addition to erectile dysfunction, urinary incontinence is the most common functional limitation after radical prostatectomy (RPE) for prostate cancer (PCa). The German S3 guideline recommends informing patients about possible effects of the therapy options, including incontinence. However, only little data on continence from routine care in German-speaking countries after RPE are currently available, which makes it difficult to inform patients. OBJECTIVE The aim of this work is to present data on the frequency and severity of urinary incontinence after RPE from routine care. MATERIALS AND METHODS Information from the PCO (Prostate Cancer Outcomes) study is used, which was collected between 2016 and 2022 in 125 German Cancer Society (DKG)-certified prostate cancer centers in 17,149 patients using the Expanded Prostate Cancer Index Composite Short Form (EPIC-26). Changes in the "incontinence" score before (T0) and 12 months after RPE (T1) and the proportion of patients who used pads, stratified by age and risk group, are reported. RESULTS The average score for urinary incontinence (value range: 0-worst possible to 100-best possible) was 93 points at T0 and 73 points 12 months later. At T0, 97% of the patients did not use a pad, compared to 56% at T1. 43% of the patients who did not use a pad before surgery used at least one pad a day 12 months later, while 13% use two or more. The proportion of patients using pads differs by age and risk classification. CONCLUSION The results provide a comprehensive insight into functional outcome 12 months after RPE and can be taken into account when informing patients.
Collapse
Affiliation(s)
- Christoph Kowalski
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland.
| | - Nora Tabea Sibert
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland
| | - Peter Hammerer
- Städtisches Klinikum Braunschweig, Braunschweig, Deutschland
| | - Simone Wesselmann
- Deutsche Krebsgesellschaft, Berlin, Kuno-Fischer-Str. 8, 14057, Berlin, Deutschland
| | - Günter Feick
- Bundesverband Prostatakrebs Selbsthilfe, Bonn, Deutschland
| | | | | | | | | | | | - Thomas Knoll
- Klinikum Sindelfingen-Böblingen, Sindelfingen, Deutschland
| | | | - Gregor Duwe
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | | | | | | | - Gerd Lümmen
- GFO Kliniken Troisdorf, Troisdorf, Deutschland
| | - Anna Katharina Seitz
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Jesco Pfitzenmaier
- Ev. Klinikum Bethel, Universitätsklinikum OWL d, Universität Bielefeld, Bielefeld, Deutschland
| | | | - Marko Brock
- Stiftungsklinikum PROSELIS Recklinghausen, Recklinghausen, Deutschland
| | | | | | | | - Tim Häfner
- Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Amir Hamza
- Klinikum St. Georg Leipzig, Leipzig, Deutschland
| | - Hans Schmelz
- BundeswehrZentralkrankenhaus Koblenz, Koblenz, Deutschland
| | - Jürgen Haas
- Klinikum am Steinenberg, Reutlingen, Deutschland
| | | | | | | | - Alexander Winter
- Universitätsklinik für Urologie, Klinikum Oldenburg, Department für Humanmedizin, Fakultät für Medizin und Gesundheitswissenschaften, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - George Kedia
- DIAKOVERE Friederikenstift, Hannover, Deutschland
| | | | - Zoltan Varga
- SRH Kliniken Landkreis Sigmaringen, Sigmaringen, Deutschland
| | | | - Matthias Richter
- Kliniken Maria Hilf Mönchengladbach, Mönchengladbach, Deutschland
| | - Florian Distler
- Universitätsklinik der Paracelsus, Privatuniversität am Klinikum Nürnberg, Nürnberg, Deutschland
| | - Jörg Simon
- Ortenau-Klinikum Offenburg, Offenburg, Deutschland
| | | | | | | | | | | | | | - Nina N Harke
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | | | | | | | - Pierre Tennstedt
- Martini Klinik am Universitätsklinikum Hamburg-Eppendorf, Hamburg-Eppendorf, Deutschland
| | | |
Collapse
|
2
|
Tiruye T, O'Callaghan M, Ettridge K, Moretti K, Jay A, Higgs B, Santoro K, Kichenadasse G, Beckmann K. Clinical and functional outcomes for risk-appropriate treatments for prostate cancer. BJUI COMPASS 2024; 5:109-120. [PMID: 38179028 PMCID: PMC10764171 DOI: 10.1002/bco2.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives To describe real-world clinical and functional outcomes in an Australian cohort of men with localised prostate cancer according to treatment type and risk category. Subjects and methods Men diagnosed from 2008 to 2018 who were enrolled in South Australian Prostate Cancer Clinical Outcomes Collaborative registry-a multi-institutional prospective clinical registry-were studied. The main outcome measures were overall survival, cancer-specific survival, decline in functional outcomes, biochemical recurrence and transition to active treatment following active surveillance. Multivariable adjusted models were applied to estimate outcomes. Results Of the 8513 eligible men, majority of men (46%) underwent radical prostatectomy (RP) followed by external beam radiation therapy with or without androgen deprivation therapy (EBRT +/- ADT) in 22% of the cohort. Five-year overall survival was above 91%, and 5-year prostate cancer-specific survival was above 97% in the low- and intermediate-risk categories across all treatments. Five-year prostate cancer-specific survival in the active surveillance group was 100%. About 37% of men with high-risk disease treated with RP and 17% of men treated with EBRT +/- ADT experienced biochemical recurrence within 5 years of treatment. Of men on active surveillance, 15% of those with low risk and 20% with intermediate risk converted to active treatment within 2 years. The decline in urinary continence and sexual function 12 months after treatment was greatest among men who underwent RP while the decline in bowel function was greatest for men who received EBRT +/- ADT. Conclusion This contemporary real-world evidence on risk-appropriate treatment outcomes helps inform treatment decision-making for clinicians and patients.
Collapse
Affiliation(s)
- Tenaw Tiruye
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- Public Health DepartmentDebre Markos UniversityDebre MarkosEthiopia
| | - Michael O'Callaghan
- South Australian Prostate Cancer Clinical Outcomes CollaborativeAdelaideAustralia
- Flinders Health and Medical Research InstituteFlinders UniversityAdelaideAustralia
- Discipline of MedicineUniversity of AdelaideAdelaideAustralia
- Flinders Medical CentreBedford ParkAustralia
| | - Kerry Ettridge
- Health Policy CentreSouth Australian Health and Medical Research InstituteAdelaideAustralia
- School of Public HealthUniversity of AdelaideAdelaideAustralia
| | - Kim Moretti
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- South Australian Prostate Cancer Clinical Outcomes CollaborativeAdelaideAustralia
- Discipline of SurgeryUniversity of AdelaideAdelaideAustralia
| | - Alex Jay
- Flinders Medical CentreBedford ParkAustralia
| | - Braden Higgs
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
- Department of Radiation OncologyRoyal Adelaide HospitalAdelaideAustralia
| | - Kerry Santoro
- Southern Adelaide Local Health NetworkAdelaideAustralia
| | - Ganessan Kichenadasse
- Flinders Health and Medical Research InstituteFlinders UniversityAdelaideAustralia
- Flinders Medical CentreBedford ParkAustralia
| | - Kerri Beckmann
- Cancer Epidemiology and Population Health Research Group, Allied Health and Human PerformanceUniversity of South AustraliaAdelaideAustralia
| |
Collapse
|