Open retropubic radical prostatectomy versus external beam radiation therapy for localized prostate cancer – patient-reported outcomes

Abstract

Introduction/Objective Active treatment options for localized prostate cancer (LPCa) include surgery and radiotherapy with androgen deprivation therapy (ADT) in selected cases, but all options have side effects, mainly addressed to urinary, sexual, and bowel function. Our study aimed to assess and compare patient-reported outcome measures (PROMs) after open retropubic radical prostatectomy (ORRP) or external beam radiotherapy (EBRT).

Methods Between June 2019 and May 2021, a total of 120 patients, with LPCa had undergone active treatment, as follow: ORRP – 60 patients and EBRT – 60 patients. A validated questionnaire, the Expanded Prostate Cancer Index Composite Short Form (EPIC-26) instrument was used to assess PROM, through the following domains: urinary, sexual and bowel. Patients completed a questionnaire at baseline and six, 12, and 24 months after primary treatment.

Results All urinary scores had statistically significant interaction between time and group. After six, 12, and 24 months, all urinary scores were statistically significantly lower in the ORRP group. After 12 and 24 months, bowel score values were statistically significantly lower in patients in the ERBT group. Sexual scores change statistically significant during the follow-up period, without difference between the groups (p < 0.05).

Conclusion Both ORRP and EBRT are associated with decline of sexual scores. ORRP showed significant variations in all urinary scores, with more pronounced negative impact on urinary symptoms compared to EBRT during the entire follow-up period. Bowel scores are lower in EBRT.

Keywords: localized prostate cancer; open retropubic radical prostatectomy; external beam radiotherapy; patient-reported outcomes