Urinary function and quality of life after radiotherapy for prostate cancer in patients with prior history of surgical treatment for benign prostatic hyperplasia

Abstract

BackgroundTo evaluate long-term IPSS score and urinary quality of life after radiotherapy for prostate cancer, in patients with prior history of surgical treatment for benign prostatic hyperplasia (BPH).MethodsIn this retrospective study, we reviewed medical records of patients treated in our department, between 2007 and 2013 with surgery for BPH followed by radiotherapy for localized prostate cancer. Patients were contacted to fill in IPSS questionnaire and they were also asked for urinary quality of life. Predictive factors known to be associated with bad urinary function were also analysed.ResultsFifty-nine patients were included in our study. Median age was 70 years. Median follow-up was 4.6 years. Median radiotherapy dose was 78 Gy (5 × 2 Gy/week). Thirty patients (48.5%) received hormone therapy in combination with RT. Main surgery indications were urinary symptoms (65%) and urinary retention (20%). Five-year biochemical-disease free survival was 75% and 5-year clinical relapse free survival was 84%. At the time of the study, the IPSS after radiotherapy was as follows: 0–7: 77.6%; 8–19:20.7%; 20–35: 1.7%. Urinary quality of life was satisfactory for 74.2% of patients. After multivariate analysis, a high dose of RT and a medical history of hypertension were associated with a poorer quality of urinary life (p = 0.04).ConclusionExternal radiotherapy remains an appropriate treatment option without a major risk for deterioration in urinary function in patient with antecedent surgery for BPH. High dose of RT and a medical history of hypertension were associated with a poorer quality of urinary life.

Surgical Treatments of Benign Prostatic Hyperplasia and Prostate Cancer Stereotactic Radiotherapy: Impact on Long-Term Genitourinary Toxicity

“…In our study we observed that the volume of the intraprostatic postsurgical cavity was correlated with an increased risk of developing genitourinary toxicities. This association was not observed in a series of 59 patients treated with normofractionated EBRT and a prior medical history of surgical treatment of BPH (including eight cases treated with adenomectomy) [21]. Nevertheless, direct comparison between the two studies cannot be carried out, as to the best of our knowledge our study was the only one to estimate the resection cavity volume on the planning MRI, in contrast to the other study that was based on the pathology weight of resected prostate.…”

Incidental prostate cancer diagnosed after surgical treatment of benign prostatic hyperplasia

“…Also, there is a concern that radical prostatectomy can be overtreatment as some patients will be reported as pT0. Radiotherapy is an effective treatment method with acceptable toxicity in patients who underwent TURP, incontinence rates are slightly higher compared to the patients without TURP (24,25). In this study, data on the continence status of patients who underwent radical prostatectomy and radiotherapy are lacking.…”

<p>The Management of Patients Diagnosed with Incidental Prostate Cancer: Narrative Review</p>

“…53 Late urinary toxicity rate was diminished in patients treated by modern irradiation techniques such as IMRT. 47 Zapatero et al 54 demonstrated that late urinary complications with high-dose IMRT compared with 3DCRT were lower despite higher radiation dose (80.7 Gy vs 78.7 Gy, p<0.001).…”

“…The incidence of severe long-term urinary toxicities is similar to those without a history of TURP. 47 Devisetty et al reported severe GU toxicity in patients who underwent external beam radiotherapy (EBRT) after TURP, but toxicity tends not to persist. 48 Mélanie Guilhen et al 47 reported External RT is a good option without a major hazard for urinary toxicity in a patient with a history of previous TURP.…”

“…47 Devisetty et al reported severe GU toxicity in patients who underwent external beam radiotherapy (EBRT) after TURP, but toxicity tends not to persist. 48 Mélanie Guilhen et al 47 reported External RT is a good option without a major hazard for urinary toxicity in a patient with a history of previous TURP. Lee et al 49 demonstrated that late urinary incontinence occurs in 2% vs 0.2% of patients after RT with or without a history of TURP, respectively.…”