Assessment of Return to Baseline Urinary and Sexual Function Following Primary Focal Cryotherapy for Nonmetastatic Prostate Cancer.

Cryotherapy Erectile Dysfunction / therapy Humans Male Prostatic Neoplasms / surgery
Clinically significant prostate cancer Cryotherapy Focal therapy International Index of Erectile Function International Prostate Symptom Score Patient-reported outcome measure Sexual function Urinary function

Journal

European urology focus
ISSN: 2405-4569
Titre abrégé: Eur Urol Focus
Pays: Netherlands
ID NLM: 101665661

Informations de publication

Date de publication:
03 2021
Historique:
received: 31 03 2019
revised: 11 08 2019
accepted: 04 09 2019
pubmed: 9 10 2019
medline: 1 4 2022
entrez: 9 10 2019
Statut: ppublish

Résumé

The oncological outcomes in men with clinically significant prostate cancer following focal cryotherapy are promising, although functional outcomes are under-reported. To determine the impact of focal cryotherapy on urinary and sexual function, specifically assessing return to baseline function. Between October 2013 and November 2016, 58 of 122 men who underwent focal cryotherapy for predominantly anterior clinically significant localised prostate cancer within a prospective registry returned patient-reported outcome measure questionnaires, which included International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-15) questionnaires. Standard cryotherapy procedure using either the SeedNet or the Visual-ICE cryotherapy system. Primary outcome was return to baseline function of IPSS score and IIEF erectile function (EF) subdomain. Cumulative incidence and Cox-regression analyses were performed. Probability of returning to baseline IPSS function was 78% at 12 mo and 87% at both 18 and 24 mo, with recovery seen up to 18 mo. For IIEF (EF domain), the probability of returning to baseline function was 85% at 12 mo and 89% at both 18 and 24 mo, with recovery seen up to 18 mo. Only the preoperative IIEF-EF score was associated with a poor outcome (hazard ratio 0.96, 95% confidence interval 0.93-0.999, p =  0.04). The main limitation was that only half of the patients returned their questionnaires. In men undergoing primary focal cryotherapy, there is a high degree of preservation of urinary and erectile function with return to baseline function occurring from 3 mo and continuing up to 18 mo after focal cryotherapy. In men who underwent focal cryotherapy for prostate cancer, approximately nine in 10 returned to their baseline urinary and sexual function. Keeping in mind that level 1 evidence and long-term data are still needed, in men who wish to preserve urinary and sexual function, focal cryotherapy may be considered an alternative treatment option to radical therapy.

Sections du résumé

BACKGROUND
The oncological outcomes in men with clinically significant prostate cancer following focal cryotherapy are promising, although functional outcomes are under-reported.
OBJECTIVE
To determine the impact of focal cryotherapy on urinary and sexual function, specifically assessing return to baseline function.
DESIGN, SETTING, AND PARTICIPANTS
Between October 2013 and November 2016, 58 of 122 men who underwent focal cryotherapy for predominantly anterior clinically significant localised prostate cancer within a prospective registry returned patient-reported outcome measure questionnaires, which included International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-15) questionnaires.
INTERVENTION
Standard cryotherapy procedure using either the SeedNet or the Visual-ICE cryotherapy system.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
Primary outcome was return to baseline function of IPSS score and IIEF erectile function (EF) subdomain. Cumulative incidence and Cox-regression analyses were performed.
RESULTS AND LIMITATIONS
Probability of returning to baseline IPSS function was 78% at 12 mo and 87% at both 18 and 24 mo, with recovery seen up to 18 mo. For IIEF (EF domain), the probability of returning to baseline function was 85% at 12 mo and 89% at both 18 and 24 mo, with recovery seen up to 18 mo. Only the preoperative IIEF-EF score was associated with a poor outcome (hazard ratio 0.96, 95% confidence interval 0.93-0.999, p =  0.04). The main limitation was that only half of the patients returned their questionnaires.
CONCLUSIONS
In men undergoing primary focal cryotherapy, there is a high degree of preservation of urinary and erectile function with return to baseline function occurring from 3 mo and continuing up to 18 mo after focal cryotherapy.
PATIENT SUMMARY
In men who underwent focal cryotherapy for prostate cancer, approximately nine in 10 returned to their baseline urinary and sexual function. Keeping in mind that level 1 evidence and long-term data are still needed, in men who wish to preserve urinary and sexual function, focal cryotherapy may be considered an alternative treatment option to radical therapy.

Identifiants

DOI: 10.1016/j.euf.2019.09.004 PMID: 31590961
pubmed: 31590961
pii: S2405-4569(19)30279-2
doi: 10.1016/j.euf.2019.09.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

301-308

Subventions

Organisme : Wellcome Trust
ID : 204998/Z/16/Z
Pays : United Kingdom

Informations de copyright

Copyright © 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Auteurs

Taimur T Shah (TT)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Division of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, University College London Hospital (UCLH), UK. Electronic address: t.shah@imperial.ac.uk.

Max Peters (M)

Department of Radiotherapy, University Medical Centre, Utrecht, The Netherlands.

Saiful Miah (S)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Division of Surgery and Interventional Sciences, University College London, London, UK.

David Eldred-Evans (D)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

Tet Yap (T)

Department of Urology, Guy's Hospital, Great Maze Pond, London, UK.

Feargus Hosking-Jervis (F)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

Tim Dudderidge (T)

Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.

Richard G Hindley (RG)

Department of Urology, University College London Hospital (UCLH), UK; Department of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.

Stuart McCracken (S)

Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

Damian Greene (D)

Department of Urology, Sunderland Royal Hospital, Sunderland, UK.

Raj Nigam (R)

Department of Urology, Royal Surrey County Hospital NHS Trust, UK.

Massimo Valerio (M)

Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Mathias Winkler (M)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Jaspal Virdi (J)

Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.

Manit Arya (M)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Division of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, University College London Hospital (UCLH), UK; Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.

Hashim U Ahmed (HU)

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Suks Minhas (S)

Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

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Classifications MeSH

questionsmedicales.fr › Thérapeutique › Cryothérapie › Assessment of Return to Baseline Urinary and...
questionsmedicales.fr › Troubles mentaux › Dysfonctionnements sexuels psychogènes › Dysfonctionnement érectile › Assessment of Return to Baseline Urinary and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Assessment of Return to Baseline Urinary and...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › Assessment of Return to Baseline Urinary and...