Functional Analysis After Radical Prostatectomy, Radiation Therapy, Or Multimodal Therapy For Prostate Cancer Therapy Using The Seer-Medicare Database

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making III (MP23)1 Sep 2021MP23-12 FUNCTIONAL ANALYSIS AFTER RADICAL PROSTATECTOMY, RADIATION THERAPY, OR MULTIMODAL THERAPY FOR PROSTATE CANCER THERAPY USING THE SEER-MEDICARE DATABASE Alexandra C. Muise, Jill C. Buckley, Michael M. Pan, and Brent Rose Alexandra C. MuiseAlexandra C. Muise More articles by this author , Jill C. BuckleyJill C. Buckley More articles by this author , Michael M. PanMichael M. Pan More articles by this author , and Brent RoseBrent Rose More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002014.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior studies have used patient reported outcomes to show the impact of primary radical prostatectomy or radiation therapy on urinary and sexual function after treatment of prostate cancer. We sought to investigate the impact of both primary as well as multimodal therapy on erectile dysfunction (ED) and urinary incontinence therapies among patients in the SEER-Medicare database. METHODS: We used the SEER-Medicare database to identify men aged 66 or older diagnosed with primary prostate cancer in 2004-2013 who received RT, RP, or both. The final cohort was 67,565 after excluding patients with non-continuous Medicare coverage, other malignancy, or missing PSA values. Patients were classified as RT only (n=47,731), RP only (n=16,294), RT then RP (n=300), or RP then RT (n=3,240). Urinary incontinence and ED therapy utilization was captured using Medicare claims. Fine and Gray regression with covariates was used to estimate hazard ratios (HRs) for association between therapy utilization and prostate cancer treatment. RESULTS: Multivariable analysis indicated that patients in the RP only group were 2.03 times as likely to receive any ED therapy (p <0.0001) and 1.73 times as likely to receive any urinary incontinence therapy (p <0.0001) compared to those in the RT only group. The RT then RP and the RP then RT groups were also more likely to receive ED (RT then RP HR: 2.57; p=0.0003 | RP then RT HR: 2.13; p <0.0001) and urinary incontinence therapy (RT then RP HR: 2.47; p <0.0001 | RP then RT HR: 2.21; p <0.0001) compared to the RT only group. Among therapy subtypes, patients in the RP only, RT then RP, and RP then RT groups were more likely to receive a definitive incontinence procedure as well as undergo a penile prosthesis compared to those in the RT only group. CONCLUSIONS: This population-based study demonstrates that, for patients over 66 with Medicare, RT alone is associated with fewer therapies for ED and urinary incontinence compared to RP alone. Patients who undergo multimodal therapy required more treatment for erectile dysfunction and incontinence than patients who undergo a single treatment modality. This is important for patient counseling in the setting of cancer survivorship. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e406-e406 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexandra C. Muise More articles by this author Jill C. Buckley More articles by this author Michael M. Pan More articles by this author Brent Rose More articles by this author Expand All Advertisement Loading ...