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. 2014 Jul;8(7-8):253-8.
doi: 10.5489/cuaj.1764.

Long-term complications in men who have early or late radiotherapy after radical prostatectomy

Robert J Sowerby  1 , Johan Gani  2 , Harold Yim  1 , Sidney B Radomski  1 , Charles Catton  3
Affiliations

Long-term complications in men who have early or late radiotherapy after radical prostatectomy

Robert J Sowerby et al. Can Urol Assoc J. 2014 Jul.

Abstract

Introduction: Choosing adjuvant radiotherapy (RT) or salvage RT after radical prostatectomy (RP) for locally advanced prostate cancer is controversial. Performing RT early after RP may increase the risk of urinary complications compared to RT performed later. We evaluated the urinary complication rates of men treated with surgery followed by early or late RT.

Methods: Using a retrospective chart review, we compared rates of urinary incontinence (UI), bladder neck contracture (BNC), or urethral stricture in men with prostate cancer treated with early RT (<6 months after RP) or late RT (≥6 months after RP), 3 years after RT.

Results: In total, 652 patients (between 2000 and 2007) underwent early RT (162, 24.8%) or late RT (490, 75.2%) after RP. The mean time to early RT was 3.6 months (range: 1-5 months) and to late RT was 30.1 months (range: 6-171 months). At 3 years post-RT, UI rates were similar in the early RT and the late RT groups (24.5% vs. 23.3%, respectively, p = 0.79). Prior to RT, 27/652 (4%) patients had a BNC and 11/652 (1.7%) had a urethral stricture, of which only 1 BNC persisted at 3 years post-RT. After RT, 17/652 (2.6%) BNC and 4/652 (0.6%) urethral stricture developed; of these, 6 BNC and 2 urethral strictures persisted at 3 years.

Conclusion: Rates of UI, BNC, and urethral stricture were similar with early and late RT at 3 years post-RT. These findings suggest that the timing of RT after RP does not alter the incidences of these urinary complications and can aid in the decision-making process regarding adjuvant RT versus salvage RT.

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Figures

Fig. 1.
Fig. 1.
Number of patients with UI, per-year, who developed before (preexisting) or after (new-onset) RT in the early and late RT groups. RT: radiotherapy; UI: urinary incontinence.
Fig. 2.
Fig. 2.
Number of patients with BNC that developed post-radiotherapy (new and persistent) in the early and late RT groups. RT: radiotherapy; BNC: bladder neck contracture.
Fig. 3.
Fig. 3.
Number of patients with US who developed post-RT (new and persistent) in the early and late RT groups. RT: radiotherapy; US: urethral stricture.
See this image and copyright information in PMC

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