Neoadjuvant Leuprolide Therapy with Radical Prostatectomy: Long-term Effects on Health-related Quality of Life.
Eur Urol Focus
; 7(4): 779-787, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-32165116
ABSTRACT
BACKGROUND:
Neoadjuvant androgen ablation (neoadjuvant androgen deprivation therapy [NADT]) is used prior to radical prostatectomy, contrary to guidelines, but its long-term effects on quality of life is unknown.OBJECTIVE:
To determine the effect of NADT on patient's long-term recovery following surgery. DESIGN, SETTING, ANDPARTICIPANTS:
From March 2011 to August 2013, 5808 men with newly diagnosed prostate were followed up to 24 mo. A cohort of men who received NADT prior to robotic-assisted laparoscopic prostatectomy (RALP; n=51) was compared 13 with a matched group that underwent RALP only (n=153). OUTCOME MEASUREMENTS AND STATISTICALANALYSIS:
Patients were matched on Charlson comorbidities, biopsy Gleason score, and node status on final pathology. The Kruskall-Wallis test was used to compare the groups on their bowel, urinary, sexual, and hormonal domains of the 26-item Expanded Prostate Cancer Index Composite at baseline and at 1, 3, 6, 12, 18, and 24 mo postoperatively. RESULTS ANDLIMITATIONS:
The urinary irritative, urinary incontinence, and bowel domains were similar in the two groups during the 24 mo (p=0.832, 0.901, and 0.732, respectively). In the hormonal domain, the NADT group did worse (p<0.001). The sexual domain was also worse for the NADT group. However, when accounting for nerve sparing, there was no significant difference in sexual outcomes between the two groups (p=0.069).CONCLUSIONS:
Patients who received NADT prior to RALP do not have worse sexual function, but have worse hormonal scores for up to 2yr after surgery. PATIENTSUMMARY:
Neoadjuvant androgen deprivation therapy (NADT) is administered prior to robotic-assisted laparoscopic prostatectomy (RALP), contrary to clinical guidelines. NADT may not have worse sexual function outcomes up to 2yr after RALP.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Incontinência Urinária
Tipo de estudo:
Guideline
Limite:
Humans
/
Male
Idioma:
En
Revista:
Eur Urol Focus
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos