Prostate volume, baseline urinary symptoms, and their association with post-treatment urinary function in men treated for localized prostate cancer

You have accessJournal of UrologyCME1 May 2022PD27-07 PROSTATE VOLUME, BASELINE URINARY SYMPTOMS, AND THEIR ASSOCIATION WITH POST-TREATMENT URINARY FUNCTION IN MEN TREATED FOR LOCALIZED PROSTATE CANCER Jacob Tallman, Christopher Wallis, Li-Ching Huang, Zhiguo Zhao, David Penson, Tatsuki Koyama, Ralph Conwill, Michael Goodman, Ann Hamilton, Xiao-Cheng Wu, Lisa Paddock, Antoinette Stroup, Matthew Cooperberg, Mia Hashibe, Brock O'Neil, Sherrie Kaplan, Sheldon Greenfield, Karen Hoffman, and Daniel Barocas Jacob TallmanJacob Tallman More articles by this author , Christopher WallisChristopher Wallis More articles by this author , Li-Ching HuangLi-Ching Huang More articles by this author , Zhiguo ZhaoZhiguo Zhao More articles by this author , David PensonDavid Penson More articles by this author , Tatsuki KoyamaTatsuki Koyama More articles by this author , Ralph ConwillRalph Conwill More articles by this author , Michael GoodmanMichael Goodman More articles by this author , Ann HamiltonAnn Hamilton More articles by this author , Xiao-Cheng WuXiao-Cheng Wu More articles by this author , Lisa PaddockLisa Paddock More articles by this author , Antoinette StroupAntoinette Stroup More articles by this author , Matthew CooperbergMatthew Cooperberg More articles by this author , Mia HashibeMia Hashibe More articles by this author , Brock O'NeilBrock O'Neil More articles by this author , Sherrie KaplanSherrie Kaplan More articles by this author , Sheldon GreenfieldSheldon Greenfield More articles by this author , Karen HoffmanKaren Hoffman More articles by this author , and Daniel BarocasDaniel Barocas More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002575.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While a patient’s prostate volume (PV) and baseline lower urinary tract symptoms (LUTS) often contribute to decision-making in men with localized PCa, it is unknown to what degree PV and LUTS are associated with treatment choice and post-treatment urinary function. We hypothesized that larger PV and worse baseline LUTS would be associated with choosing surgery or active surveillance over radiation therapy (RT) and with larger improvement in urinary symptoms after treatment. METHODS: CEASAR is a prospective cohort study that enrolled men with localized PCa from 2011-2012. 1823 men who completed both baseline and post-treatment surveys were included. Patient-reported health-related quality of life (HRQOL) was evaluated using the Expanded Prostate Index Composite (EPIC-26) with up to 5 years follow up. Men were grouped by PV (0-30cc, 31-50, 51-70, and 70+) and baseline LUTS (urinary irritative domain score 0-75, 76-85, 86-95, and 95-100). We evaluated the association of baseline PV and LUTS with post-treatment urinary function using multivariable analyses. RESULTS: Median age was 64 (IQR 59-69) years. 896 (51%) had grade group 1 PCa and 485 (28%) grade group 2. 961 (53%) received surgery, 595 (33%) RT, and 267 (14%) active surveillance. Larger PV was weakly associated with worse LUTS at baseline (R = -0.17; p < 0.001). On multivariable analysis by PV, there were no clinically significant differences in treatment choice or post-treatment LUTS. Men with optimal baseline urinary function had less LUTS post-treatment compared to men with worse baseline function (Table 1). Men with poor baseline LUTS saw improvement post-treatment; surgery led to greater improvement than RT. These differences meet the minimum clinically important difference (9 points). Subgroup analysis excluding androgen deprivation therapy use had no significant impact on the results. CONCLUSIONS: While baseline PV had no significant association with post-treatment LUTS, worse baseline LUTS were associated with significantly worse LUTS after treatment with a durable effect out to 5 years. Men with poor LUTS tend to improve with treatment, more so with surgery than RT. Urologists should consider patient’s baseline LUTS when counseling about treatment options for PCa. Source of Funding: AHRQ: 1R01HS019356, 1R01HS022640. PCORI: CE-12-11-4667. NCI: 5T32CA106183, R01CA230352. NCATS: UL1TR000011 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e496 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacob Tallman More articles by this author Christopher Wallis More articles by this author Li-Ching Huang More articles by this author Zhiguo Zhao More articles by this author David Penson More articles by this author Tatsuki Koyama More articles by this author Ralph Conwill More articles by this author Michael Goodman More articles by this author Ann Hamilton More articles by this author Xiao-Cheng Wu More articles by this author Lisa Paddock More articles by this author Antoinette Stroup More articles by this author Matthew Cooperberg More articles by this author Mia Hashibe More articles by this author Brock O'Neil More articles by this author Sherrie Kaplan More articles by this author Sheldon Greenfield More articles by this author Karen Hoffman More articles by this author Daniel Barocas More articles by this author Expand All Advertisement PDF DownloadLoading ...