Loading…
Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?
Background To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation. Methods Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we...
Saved in:
| Published in: | Prostate cancer and prostatic diseases 2021-06, Vol.24 (2), p.507-513 |
|---|---|
| Main Authors: | , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | |
|---|---|
| cites | cdi_FETCH-LOGICAL-c424t-15495bd0034c8666ce6131f843fa4e3e856ada03097106d4bfacc2e855a22cf13 |
| container_end_page | 513 |
| container_issue | 2 |
| container_start_page | 507 |
| container_title | Prostate cancer and prostatic diseases |
| container_volume | 24 |
| creator | ElShafei, Ahmed DeWitt-Foy, Molly Calaway, Adam Fernstrum, Austin J. Hijaz, Adonis Muncey, Wade Alfahmy, Anood Mahran, Amr Mishra, Kirtishri Stephen Jones, J. Polascik, Thomas J. |
| description | Background
To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation.
Methods
Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation (
n
= 6), transurethral microwave thermotherapy (
n
= 9), or transurethral resection of the prostate (
n
= 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy.
Results
In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%,
p
= 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%,
p
> 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula (
p
= 0.84) or new-onset erectile dysfunction (ED) at 12 months (
p
= 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%,
p
= 0.015) and new-onset urinary incontinence (OR 2.13,
p
|
| doi_str_mv | 10.1038/s41391-020-00306-z |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480436730</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A662388619</galeid><sourcerecordid>A662388619</sourcerecordid><originalsourceid>FETCH-LOGICAL-c424t-15495bd0034c8666ce6131f843fa4e3e856ada03097106d4bfacc2e855a22cf13</originalsourceid><addsrcrecordid>eNp9ks1u1DAUhSMEoqXwAixQJCTEJsV_cZwVKi1QpEqwgLXlca5nUjlxsR3QzEv1FblpBtoihLJwfP2dY_v4FsVzSo4p4epNEpS3tCKMVIRwIqvdg-KQikZWtSTqIf5zWVeNqtlB8SSlS0JIS1vyuDjgXCgumTwsrs8CpPIq9iGWaYrr3hpf9mOG-APG3IcRp3kD0VxtS4fMuy_npXEObJ7LZRht8GFR4aqbRrsXhSnbMKC3cWg27zCYuC1_boKHau3N2GEtpGwylDZug1l5M0tvdvEBDfsd3GXMaCG-fVo8csYneLYfj4pvH95_PT2vLj5__HR6clFZwUSuaC3aetVhLMIqKaUFSTl1SnBnBHBQtTSdwdDahhLZiZUz1jIs14Yx6yg_Kl4vvniA7xOkrIc-WfB4cAhT0kwoIrhsOEH05V_oZZgiZoBUzVoMXdTNLbU2HnQ_upCjsbOpPpGScaUkbZE6_geFXwdDb8MIrsf6PcGrO4INGJ83KfhpjjLdB9kCWkw0RXB6_ySaEj23k17aSWM76Zt20jsUvdhfbVoN0P2R_O4fBPgCJFwa1xBv7_4f21-Nn9eq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2529009457</pqid></control><display><type>article</type><title>Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?</title><source>Springer Link</source><creator>ElShafei, Ahmed ; DeWitt-Foy, Molly ; Calaway, Adam ; Fernstrum, Austin J. ; Hijaz, Adonis ; Muncey, Wade ; Alfahmy, Anood ; Mahran, Amr ; Mishra, Kirtishri ; Stephen Jones, J. ; Polascik, Thomas J.</creator><creatorcontrib>ElShafei, Ahmed ; DeWitt-Foy, Molly ; Calaway, Adam ; Fernstrum, Austin J. ; Hijaz, Adonis ; Muncey, Wade ; Alfahmy, Anood ; Mahran, Amr ; Mishra, Kirtishri ; Stephen Jones, J. ; Polascik, Thomas J.</creatorcontrib><description>Background
To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation.
Methods
Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation (
n
= 6), transurethral microwave thermotherapy (
n
= 9), or transurethral resection of the prostate (
n
= 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy.
Results
In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%,
p
= 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%,
p
> 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula (
p
= 0.84) or new-onset erectile dysfunction (ED) at 12 months (
p
= 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%,
p
= 0.015) and new-onset urinary incontinence (OR 2.13,
p
< 0.001). The estimated 5 years Kaplan–Meier survival analysis showed no statistically significant difference (
p
= 0.3) in biochemical progression free survival between those who underwent interventional BPH therapy compared with those who did not. Local disease recurrence assessed by post cryoablation positive for-cause prostate biopsy showed no significant difference between the two groups (25.4% vs. 28.7%,
p
= 0.59).
Conclusions
Prior interventional BPH therapy did not affect the oncologic outcomes nor did it increase the risk of rectourethral fistula or ED in sexually performing patients prior to cryosurgery. Prior interventional BPH therapy was associated with increased risk of urinary retention and incontinence after primary whole-gland prostate cryoablation for prostate cancer.</description><identifier>ISSN: 1365-7852</identifier><identifier>EISSN: 1476-5608</identifier><identifier>DOI: 10.1038/s41391-020-00306-z</identifier><identifier>PMID: 33483626</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/699/67 ; Ablation ; Ablation (Surgery) ; Aged ; Biomedical and Life Sciences ; Biomedicine ; Biopsy ; Cancer ; Cancer Research ; Care and treatment ; Comparative analysis ; Cryosurgery ; Cryosurgery - methods ; Diseases ; Erectile dysfunction ; Fistula ; Fistulae ; Follow-Up Studies ; Glands ; Humans ; Hyperplasia ; Impotence ; Male ; Oncology, Experimental ; Patients ; Preoperative Care ; Prognosis ; Prospective Studies ; Prostate cancer ; Prostatic Hyperplasia - pathology ; Prostatic Hyperplasia - surgery ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Relapse ; Reproductive Medicine ; Retention ; Risk ; Statistical analysis ; Surgery ; Survival ; Survival analysis ; Survival Rate ; Therapy ; Thermotherapy ; Transurethral Resection of Prostate - methods ; Urinary incontinence ; Urinary retention</subject><ispartof>Prostate cancer and prostatic diseases, 2021-06, Vol.24 (2), p.507-513</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2021</rights><rights>COPYRIGHT 2021 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature Limited 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c424t-15495bd0034c8666ce6131f843fa4e3e856ada03097106d4bfacc2e855a22cf13</cites><orcidid>0000-0003-0491-7468 ; 0000-0003-3690-9198 ; 0000-0001-8323-7094</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33483626$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ElShafei, Ahmed</creatorcontrib><creatorcontrib>DeWitt-Foy, Molly</creatorcontrib><creatorcontrib>Calaway, Adam</creatorcontrib><creatorcontrib>Fernstrum, Austin J.</creatorcontrib><creatorcontrib>Hijaz, Adonis</creatorcontrib><creatorcontrib>Muncey, Wade</creatorcontrib><creatorcontrib>Alfahmy, Anood</creatorcontrib><creatorcontrib>Mahran, Amr</creatorcontrib><creatorcontrib>Mishra, Kirtishri</creatorcontrib><creatorcontrib>Stephen Jones, J.</creatorcontrib><creatorcontrib>Polascik, Thomas J.</creatorcontrib><title>Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?</title><title>Prostate cancer and prostatic diseases</title><addtitle>Prostate Cancer Prostatic Dis</addtitle><addtitle>Prostate Cancer Prostatic Dis</addtitle><description>Background
To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation.
Methods
Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation (
n
= 6), transurethral microwave thermotherapy (
n
= 9), or transurethral resection of the prostate (
n
= 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy.
Results
In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%,
p
= 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%,
p
> 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula (
p
= 0.84) or new-onset erectile dysfunction (ED) at 12 months (
p
= 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%,
p
= 0.015) and new-onset urinary incontinence (OR 2.13,
p
< 0.001). The estimated 5 years Kaplan–Meier survival analysis showed no statistically significant difference (
p
= 0.3) in biochemical progression free survival between those who underwent interventional BPH therapy compared with those who did not. Local disease recurrence assessed by post cryoablation positive for-cause prostate biopsy showed no significant difference between the two groups (25.4% vs. 28.7%,
p
= 0.59).
Conclusions
Prior interventional BPH therapy did not affect the oncologic outcomes nor did it increase the risk of rectourethral fistula or ED in sexually performing patients prior to cryosurgery. Prior interventional BPH therapy was associated with increased risk of urinary retention and incontinence after primary whole-gland prostate cryoablation for prostate cancer.</description><subject>692/308/409</subject><subject>692/699/67</subject><subject>Ablation</subject><subject>Ablation (Surgery)</subject><subject>Aged</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Care and treatment</subject><subject>Comparative analysis</subject><subject>Cryosurgery</subject><subject>Cryosurgery - methods</subject><subject>Diseases</subject><subject>Erectile dysfunction</subject><subject>Fistula</subject><subject>Fistulae</subject><subject>Follow-Up Studies</subject><subject>Glands</subject><subject>Humans</subject><subject>Hyperplasia</subject><subject>Impotence</subject><subject>Male</subject><subject>Oncology, Experimental</subject><subject>Patients</subject><subject>Preoperative Care</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Prostate cancer</subject><subject>Prostatic Hyperplasia - pathology</subject><subject>Prostatic Hyperplasia - surgery</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Relapse</subject><subject>Reproductive Medicine</subject><subject>Retention</subject><subject>Risk</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Survival Rate</subject><subject>Therapy</subject><subject>Thermotherapy</subject><subject>Transurethral Resection of Prostate - methods</subject><subject>Urinary incontinence</subject><subject>Urinary retention</subject><issn>1365-7852</issn><issn>1476-5608</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9ks1u1DAUhSMEoqXwAixQJCTEJsV_cZwVKi1QpEqwgLXlca5nUjlxsR3QzEv1FblpBtoihLJwfP2dY_v4FsVzSo4p4epNEpS3tCKMVIRwIqvdg-KQikZWtSTqIf5zWVeNqtlB8SSlS0JIS1vyuDjgXCgumTwsrs8CpPIq9iGWaYrr3hpf9mOG-APG3IcRp3kD0VxtS4fMuy_npXEObJ7LZRht8GFR4aqbRrsXhSnbMKC3cWg27zCYuC1_boKHau3N2GEtpGwylDZug1l5M0tvdvEBDfsd3GXMaCG-fVo8csYneLYfj4pvH95_PT2vLj5__HR6clFZwUSuaC3aetVhLMIqKaUFSTl1SnBnBHBQtTSdwdDahhLZiZUz1jIs14Yx6yg_Kl4vvniA7xOkrIc-WfB4cAhT0kwoIrhsOEH05V_oZZgiZoBUzVoMXdTNLbU2HnQ_upCjsbOpPpGScaUkbZE6_geFXwdDb8MIrsf6PcGrO4INGJ83KfhpjjLdB9kCWkw0RXB6_ySaEj23k17aSWM76Zt20jsUvdhfbVoN0P2R_O4fBPgCJFwa1xBv7_4f21-Nn9eq</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>ElShafei, Ahmed</creator><creator>DeWitt-Foy, Molly</creator><creator>Calaway, Adam</creator><creator>Fernstrum, Austin J.</creator><creator>Hijaz, Adonis</creator><creator>Muncey, Wade</creator><creator>Alfahmy, Anood</creator><creator>Mahran, Amr</creator><creator>Mishra, Kirtishri</creator><creator>Stephen Jones, J.</creator><creator>Polascik, Thomas J.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0491-7468</orcidid><orcidid>https://orcid.org/0000-0003-3690-9198</orcidid><orcidid>https://orcid.org/0000-0001-8323-7094</orcidid></search><sort><creationdate>20210601</creationdate><title>Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?</title><author>ElShafei, Ahmed ; DeWitt-Foy, Molly ; Calaway, Adam ; Fernstrum, Austin J. ; Hijaz, Adonis ; Muncey, Wade ; Alfahmy, Anood ; Mahran, Amr ; Mishra, Kirtishri ; Stephen Jones, J. ; Polascik, Thomas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-15495bd0034c8666ce6131f843fa4e3e856ada03097106d4bfacc2e855a22cf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>692/308/409</topic><topic>692/699/67</topic><topic>Ablation</topic><topic>Ablation (Surgery)</topic><topic>Aged</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Care and treatment</topic><topic>Comparative analysis</topic><topic>Cryosurgery</topic><topic>Cryosurgery - methods</topic><topic>Diseases</topic><topic>Erectile dysfunction</topic><topic>Fistula</topic><topic>Fistulae</topic><topic>Follow-Up Studies</topic><topic>Glands</topic><topic>Humans</topic><topic>Hyperplasia</topic><topic>Impotence</topic><topic>Male</topic><topic>Oncology, Experimental</topic><topic>Patients</topic><topic>Preoperative Care</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Prostate cancer</topic><topic>Prostatic Hyperplasia - pathology</topic><topic>Prostatic Hyperplasia - surgery</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Relapse</topic><topic>Reproductive Medicine</topic><topic>Retention</topic><topic>Risk</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Survival Rate</topic><topic>Therapy</topic><topic>Thermotherapy</topic><topic>Transurethral Resection of Prostate - methods</topic><topic>Urinary incontinence</topic><topic>Urinary retention</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ElShafei, Ahmed</creatorcontrib><creatorcontrib>DeWitt-Foy, Molly</creatorcontrib><creatorcontrib>Calaway, Adam</creatorcontrib><creatorcontrib>Fernstrum, Austin J.</creatorcontrib><creatorcontrib>Hijaz, Adonis</creatorcontrib><creatorcontrib>Muncey, Wade</creatorcontrib><creatorcontrib>Alfahmy, Anood</creatorcontrib><creatorcontrib>Mahran, Amr</creatorcontrib><creatorcontrib>Mishra, Kirtishri</creatorcontrib><creatorcontrib>Stephen Jones, J.</creatorcontrib><creatorcontrib>Polascik, Thomas J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Biological Science Journals</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Prostate cancer and prostatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ElShafei, Ahmed</au><au>DeWitt-Foy, Molly</au><au>Calaway, Adam</au><au>Fernstrum, Austin J.</au><au>Hijaz, Adonis</au><au>Muncey, Wade</au><au>Alfahmy, Anood</au><au>Mahran, Amr</au><au>Mishra, Kirtishri</au><au>Stephen Jones, J.</au><au>Polascik, Thomas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?</atitle><jtitle>Prostate cancer and prostatic diseases</jtitle><stitle>Prostate Cancer Prostatic Dis</stitle><addtitle>Prostate Cancer Prostatic Dis</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>24</volume><issue>2</issue><spage>507</spage><epage>513</epage><pages>507-513</pages><issn>1365-7852</issn><eissn>1476-5608</eissn><abstract>Background
To assess whether prior interventional treatment for benign prostatic hyperplasia (BPH) influences oncologic or functional outcomes following primary whole-gland prostate cryoablation.
Methods
Among 3831 men with prostate cancer who underwent primary whole-gland prostate cryoablation, we identified 160 with a history of prior BPH interventional therapy including transurethral needle ablation (
n
= 6), transurethral microwave thermotherapy (
n
= 9), or transurethral resection of the prostate (
n
= 145). Patients with a history of medically treated or unspecified BPH therapy were excluded from the study. Oncological and functional outcomes were compared between men with and without prior BPH interventional therapy.
Results
In unadjusted analyses, prior interventional BPH therapy was associated with higher risks of postoperative urinary retention (17.5% vs. 9.6%,
p
= 0.001) and new-onset urinary incontinence (39.9% vs. 19.4%,
p
> 0.001) compared with no prior therapy. Interventional BPH therapy was not correlated with the risk of developing a rectourethral fistula (
p
= 0.84) or new-onset erectile dysfunction (ED) at 12 months (
p
= 0.08) following surgery. On multivariable regression, prior interventional BPH therapy was associated with increased risk of urinary retention (OR 1.9, 95%,
p
= 0.015) and new-onset urinary incontinence (OR 2.13,
p
< 0.001). The estimated 5 years Kaplan–Meier survival analysis showed no statistically significant difference (
p
= 0.3) in biochemical progression free survival between those who underwent interventional BPH therapy compared with those who did not. Local disease recurrence assessed by post cryoablation positive for-cause prostate biopsy showed no significant difference between the two groups (25.4% vs. 28.7%,
p
= 0.59).
Conclusions
Prior interventional BPH therapy did not affect the oncologic outcomes nor did it increase the risk of rectourethral fistula or ED in sexually performing patients prior to cryosurgery. Prior interventional BPH therapy was associated with increased risk of urinary retention and incontinence after primary whole-gland prostate cryoablation for prostate cancer.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33483626</pmid><doi>10.1038/s41391-020-00306-z</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0491-7468</orcidid><orcidid>https://orcid.org/0000-0003-3690-9198</orcidid><orcidid>https://orcid.org/0000-0001-8323-7094</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1365-7852 |
| ispartof | Prostate cancer and prostatic diseases, 2021-06, Vol.24 (2), p.507-513 |
| issn | 1365-7852 1476-5608 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2480436730 |
| source | Springer Link |
| subjects | 692/308/409 692/699/67 Ablation Ablation (Surgery) Aged Biomedical and Life Sciences Biomedicine Biopsy Cancer Cancer Research Care and treatment Comparative analysis Cryosurgery Cryosurgery - methods Diseases Erectile dysfunction Fistula Fistulae Follow-Up Studies Glands Humans Hyperplasia Impotence Male Oncology, Experimental Patients Preoperative Care Prognosis Prospective Studies Prostate cancer Prostatic Hyperplasia - pathology Prostatic Hyperplasia - surgery Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Relapse Reproductive Medicine Retention Risk Statistical analysis Surgery Survival Survival analysis Survival Rate Therapy Thermotherapy Transurethral Resection of Prostate - methods Urinary incontinence Urinary retention |
| title | Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer? |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T20%3A14%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Does%20prior%20surgical%20interventional%20therapy%20for%20BPH%20affect%20the%20oncological%20or%20functional%20outcomes%20after%20primary%20whole-gland%20prostate%20cryoablation%20for%20localized%20prostate%20cancer?&rft.jtitle=Prostate%20cancer%20and%20prostatic%20diseases&rft.au=ElShafei,%20Ahmed&rft.date=2021-06-01&rft.volume=24&rft.issue=2&rft.spage=507&rft.epage=513&rft.pages=507-513&rft.issn=1365-7852&rft.eissn=1476-5608&rft_id=info:doi/10.1038/s41391-020-00306-z&rft_dat=%3Cgale_proqu%3EA662388619%3C/gale_proqu%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c424t-15495bd0034c8666ce6131f843fa4e3e856ada03097106d4bfacc2e855a22cf13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2529009457&rft_id=info:pmid/33483626&rft_galeid=A662388619&rfr_iscdi=true |