Radical prostatectomy vs external beam radiation therapy in

intermediate risk localized prostate cancer patients

- Comparative analysis of quality of life -

Olaru V.1,2, Preda A.T.1, Bratu L. 1,2, Carciumaru C.S. 1,2, Discalicau L. 1,2, Iordache A. 1, Baston C. 1,2, Sinescu I. 1,2
Fundeni Clinical Institute, Center for Uronephrology and Renal Transplantation, Bucharest, Romania 1
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 2

Introduction
 Radical prostatectomy and external beam radiation therapy are
two available initial treatment options for newly diagnosed
intermediate risk prostate cancer patients according to current
urological guidelines.
 While both therapeutical approaches provide similar oncological
results, a poor functional outcome can have a detrimental effect
on patient ‘quality of life.
 The aim of our study was to evaluate the impact of radical
prostatectomy and external beam radiation therapy on quality of
life in patients diagnosed with localized intermediate risk
prostate cancer

Material and Methods

 We performed a nonrandomized retrospective observational
study including 100 patients with newly diagnosed intermediate
risk prostate cancer according to EAU guidelines for risk
stratification treated by radical prostatectomy or external beam
radiation therapy.
Material and Methods
Functional outcome was evaluated by The
Expanded Prostate Cancer Index Composite Urinary
Assessment Questionnaire (EPIC urinary domain
only, University of Michigan) that measures the
patient-reported quality of life by scoring irritative Distribution of patients according to the average score –
and obstructive voiding symptoms, urinary EPIC questionnaire
incontinence, hematuria and global urinary 42
39
function. 50
EPIC urinary domain only score was compared with 45
a reference medium score. 40
35
The difference between cohorts was assessed by 30
the student t test and values ​of p < 0.05 were 25
considered statistically significant. 20
11

Results
15 8
10
5
At a median follow-up of 14 months, urinary 0
discomfort and irritative and obstructive voiding Radical prostatectomy External beam radiation therapy
symptoms were significantly better in patients
undergoing external beam radiation therapy (82%
vs 68% and 82% vs 64%; p<0.05). However, no
difference was reported in urinary function and
urinary incontinence between cohorts.
 EXTERNAL BEAM
RADICAL
  RADIATION p
PROSTATECTOMY
THERAPY
NUMBER OF PATIENTS 50 50  

Conclusion %
   

84%
 

78%
 

p=0.029

AVERAGE SCORE >80.2 42 39

       

In our study newly diagnosed patients with % 74% 78% p=0.73

intermediate risk localized prostate cancer FUNCTION SCORE >86.5 37 39

reported a better quality of life in terms of
urinary comfort after external beam radiation
therapy than after radical prostatectomy. In        
our opinion, these data can help urologists in
treatment decision-making process for % 82% 68% p=0.024

intermediate risk prostate cancer. DISCOMFORT SCORE >75.8 41 34

       

% 70% 74% p=0.3

INCONTINENT SCORE >83.2 35 37

       

% 82% 64% p=0.037

IRRITATIVE/OBSTRUCTIVE 41 32
SYNDROME SCORE >79.7