Individual risk prediction of urinary incontinence after prostatectomy and impact on treatment choice in patients with localized prostate cancer.

Autor: Tillier CN; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Vromans RD; Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands.; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Boekhout AH; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Veerman H; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.; Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Wollersheim BM; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Muilekom HAM; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Boellaard TN; Department of Radiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., van Leeuwen PJ; Department of Urology, Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, The Netherlands., van de Poll-Franse LV; Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.; Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.; Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands., van der Poel HG; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Neurourology and urodynamics [Neurourol Urodyn] 2021 Aug; Vol. 40 (6), pp. 1550-1558. Date of Electronic Publication: 2021 May 18.
DOI: 10.1002/nau.24703
Abstrakt: Aims: Individualized information about the risk of incontinence after prostatectomy could help patients in shared decision-making.
Methods: We compared a historical control cohort (n = 254; between June 2016 and 2017) that received standardized information about the risk of incontinence after robot-assisted radical prostatectomy (RARP) with a prospective patient cohort (n = 254; between June 2017 and May 2018) that received individualized information of the chance of recovery of incontinence within 6 months postoperatively based on the continence prediction tool (CPRED). We measured switch in treatment choice, health-related quality of life (QoL) in both cohorts and the accuracy of the CPRED tool.
Results: Patients in the individualized information group with RARP as initial preference switched more often to another treatment than patients who received standardized information (16% vs. 5%; p = 0.001). Patients in the individualized information group with a high risk of incontinence and with RARP as initial preference switched more often to other treatments than patients in intermediate/low risk of incontinence (35% vs. 9.8%; p = 0.001). Patients with a low risk of incontinence choosing RARP after individualized information were less likely to use more than one diaper a day at any time postoperative (p = 0.001) compared to men with an intermediate/high incontinence risk. Overall QoL was worse in patients with incontinence than patients with continence 6 and 12 months after RARP (respectively; p < 0.0001 and p = 0.007).
Conclusion: Personalized information about the risk of incontinence after RARP makes more patients reconsidering their initial treatment preference. The CPRED correlated strongly with continence outcome after RARP and is a useful tool for shared decision-making.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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