Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada.
Eur Urol Focus. 2017 Dec;3(6):615-620. doi: 10.1016/j.euf.2017.08.001. Epub 2017 Aug 30.
Results from population-based studies and the Prostate Testing for Cancer and Treatment trial reported worse urinary continence (UC) and erectile function (EF) for radical prostatectomy (RP) patients compared with their radiation or active surveillance counterparts.
To investigate functional outcomes for patients undergoing RP in a high-volume center.
DATA, SETTING, AND PARTICIPANTS: A total of 8573 consecutive RP patients (2008-2012) were analyzed.
RP.
Standardized questionnaires assessing EF, UC, and quality of life (QoL), were completed at baseline and annually thereafter. UC was defined as use of 0 or 1 safety pad/d, whereas the regular use of 1 pad/d was considered incontinent. EF was defined as ≥3 points in the International Index of Erectile Function question two. QoL was assessed using the EORTC-QLQ-C30 Global Health/QoL item. Statistics relied on comparison of means and proportions.
EF and UC rates significantly decreased after RP. Overall, 12-mo, 24-mo, and 36-mo EF rates were 45%, 51%, and 53%, but reached up to 65.7% in preoperatively potent patients with bilateral nerve sparing. At 36 mo, 13% reported problems in their partnership. However, at the same time point, 77% were satisfied with their sexual intercourse. UC rates were 89.1%, 91.3%, and 89.0% at 12-mo, 24-mo, and 36-mo postoperatively. Mean EORTC-QLQ-C30 scores ranged from 74 to 79 and remained constant compared to baseline.
Although varying definitions hinder direct comparisons to other studies, functional outcomes seemed favorable for patients undergoing RP in a high-volume center and most patients reported excellent QoL.
Results of functional outcomes (urinary continence and potency) after radical prostatectomy are better in a high-volume center compared with those obtained from population-based data, and most patients report excellent quality of life after radical prostatectomy.
基于人群的研究和前列腺癌检测与治疗试验的结果报告显示，与接受放射治疗或主动监测的患者相比，接受根治性前列腺切除术（RP）的患者在尿控（UC）和勃起功能（EF）方面的情况更差。
调查在高容量中心接受 RP 的患者的功能结果。
数据、设置和参与者：共分析了 8573 例连续接受 RP 的患者（2008-2012 年）。
RP。
在基线和此后每年使用标准化问卷评估 EF、UC 和生活质量（QoL）。UC 定义为每天使用 0 或 1 个安全垫，而每天使用 1 个垫则被认为是失禁。EF 定义为国际勃起功能指数问题 2 中≥3 分。QoL 使用 EORTC-QLQ-C30 全球健康/QoL 项目进行评估。统计数据依赖于均值和比例的比较。
RP 后 EF 和 UC 率显著下降。总体而言，12 个月、24 个月和 36 个月的 EF 率分别为 45%、51%和 53%，但在双侧神经保留的术前有勃起功能的患者中可达 65.7%。在 36 个月时，13%的患者报告在其伴侣关系中存在问题。然而，在同一时间点，77%的患者对其性生活感到满意。术后 12 个月、24 个月和 36 个月时的 UC 率分别为 89.1%、91.3%和 89.0%。EORTC-QLQ-C30 平均得分范围为 74 至 79，与基线相比保持不变。
尽管不同的定义阻碍了与其他研究的直接比较，但在高容量中心接受 RP 的患者的功能结果似乎较好，大多数患者报告了极好的生活质量。
与基于人群的数据相比，高容量中心接受根治性前列腺切除术的患者的功能结果（尿控和勃起功能）更好，大多数患者报告根治性前列腺切除术的生活质量极好。
