Erectile dysfunction is predictive of all‐cause mortality in patients with prostate cancer treated with permanent interstitial brachytherapy

• Published in: BJU international 2012-01, Vol.109 (2), p.220-225
• Main Authors: Bittner, Nathan, Merrick, Gregory S., Galbreath, Robert W., Butler, Wayne M., Lief, Jonathan H., Allen, Zachariah A., Wallner, Kent E.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers; Brachytherapy; Cardiovascular disease; Cardiovascular Diseases - complications; Cardiovascular Diseases - mortality; Clinical trials; Drug therapy; erectile dysfunction; Erectile Dysfunction - complications; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Medical sciences; Middle Aged; Mortality; Nephrology. Urinary tract diseases; Non tumoral diseases; Prostate cancer; Prostatic Neoplasms - complications; Prostatic Neoplasms - radiotherapy; Retrospective Studies; Risk Factors; Severity of Illness Index; Survival Analysis; Tumors of the urinary system; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10280.x

Study Type – Prognosis (individual cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? Cardiovascular disease is a leading cause of death in prostate cancer patients. Pretreatment ED is a surrogate for vascular pathology. Aggressive treatment of medical co‐morbidity in prostate cancer patients may positively impact overall survival. OBJECTIVE •  To evaluate the relationship between pre‐treatment erectile function and all‐cause mortality in patients with prostate cancer treated with brachytherapy. PATIENTS AND METHODS •  In all, 1279 consecutive patients with clinically localized prostate cancer and pre‐implant erectile function assessed by the International Index of Erectile Function‐6 (IIEF‐6) underwent brachytherapy. •  Potency was defined as an IIEF‐6 score of ≥13 without pharmacological or mechanical support. •  Patients were stratified into IIEF‐6‐score cohorts (≤12, 13–23 and 24–30). •  The median follow‐up was 5.0 years. RESULTS •  The 8‐year overall survival (OS) of the study population was 85.1%. •  The 8‐year OS for IIEF‐6scores ≤12, 13–23 and 24–30 were 78.0%, 92.8% and 91.4%, respectively (P