Late urinary morbidity and quality of life after radical prostatectomy and salvage radiotherapy for prostate cancer^*

Abstract

Objective: There is a paucity of knowledge of long-term urinary morbidity in patients treated for prostate cancer (PCa) with radical prostatectomy (RP) and salvage radiotherapy (SRT). Improved long-term survival calls for heightened awareness of late effects from radiotherapy after RP. The purpose of this study was to assess late urinary morbidity and its potential impact on quality of life (QoL) in patients treated with RP plus SRT compared with patients treated with RP alone.

Materials and methods: Long-term morbidity and QoL were evaluated using a cross-sectional design with validated questionnaires in urinary morbidity [Danish Prostatic Symptom Score (DAN-PSS)] and QoL [European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)]. Included were a total of 227 patients treated with SRT and 192 treated with RP in the periods 2006–2010 and 2005–2007, respectively.

Results: Weak stream, straining, frequency and nocturia were significantly more prevalent in patients treated with RP + SRT than in patients treated with RP alone. Patients treated with RP + SRT generally suffered from more severe urinary symptoms. The QoL scores of the two treatment groups were not statistically significantly different, but a high level of urinary morbidity was significantly related to decreased QoL (p = 0.000).

Conclusions: Patients treated with SRT have a higher rate of urinary morbidity than do patients treated with RP alone. Severe urinary morbidity was significantly related to decreased QoL, but did not differ between the two treatment groups.

Keywords:

• Late morbidity
• lower urinary tract symptoms
• patient-reported outcome
• prostatectomy
• prostatic neoplasms
• quality of life
• radiotherapy

Acknowledgements

This study was funded by Frits, Georg and Marie Cecilie Gluds Foundation. The sponsors had no role in any part of the study, including the study design, data collection, data interpretation or writing of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by Frits, Georg and Marie Cecilie Gluds Foundation. The sponsors had no role in any part of the study, including the study design, data collection, data interpretation or writing of the manuscript.