Variation in patient reported outcomes following radical prostatectomy: A bi-national registry-based study.

Autor: O'Callaghan ME; Urology Unit, Flinders Medical Centre, Adelaide, South Australia, Australia; College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia. Electronic address: michael.ocallaghan@health.sa.gov.au., Roberts MJ; Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia; Faculty of Medicine, University of Queensland Centre for Clinical Research, Brisbane, Australia., Moretti KL; South Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, South Australia, Australia; The University of Adelaide, Department of Surgery, The University of South Australia, Cancer Research Institute, Monash University, Faculty of Medicine, Nursing and Health sciences., Frydenberg M; Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Cabrini Institute, Cabrini Health, Monash, Victoria, Australia., Gilbourd D; Canberra Hospital, Canberra, ACT, Australia; Australian National University., Mark S; Department of Urology, Christchurch Hospital, Christchurch, New Zealand., Heathcote P; Princess Alexandra Hospital, Brisbane, QLD, Australia., Millar J; Alfred Health, Central Clinical School, Monash University, Monash, Victoria, Australia; Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Monash, Victoria, Australia., Pcor-Anz; School of Public Health and Preventive Medicine, Monash University, Monash, Victoria, Australia., Papa N; School of Public Health and Preventive Medicine, Monash University, Monash, Victoria, Australia.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2023 Feb; Vol. 41 (2), pp. 105.e9-105.e18. Date of Electronic Publication: 2022 Nov 25.
DOI: 10.1016/j.urolonc.2022.10.020
Abstrakt: Background and Objective: Radical prostatectomy (RP) is a common and widely used treatment for localized prostate cancer. Sequela following RP may include urinary incontinence and sexual dysfunction, outcomes which are recorded within a bi-national Prostate Cancer Outcomes Registry. The objective was to report population-wide urinary incontinence and sexual function outcomes recorded at 12 months following RP; and to quantify and explore factors associated with variation in outcome.
Materials and Methods: The Prostate Cancer Outcomes Registry of Australia and New Zealand (PCOR-ANZ) was used for this study. Participants were treated with radical prostatectomy between 2016 and 2020. Domain summary scores for urinary incontinence and sexual function from the EPIC-26 instrument were the main outcomes, taken at 12 months following surgery (6-18 months). "Major" urinary and sexual function bother were also assessed. Variation in outcomes was investigated using linear and logistic multivariable regression models adjusted for covariates: age, socioeconomic status, PSA at diagnosis, surgical technique, surgical specimen grade group, margin status, and clinician surgical volume.
Results and Conclusions: The analytic cohort included 13,083 men with the mean urinary incontinence domain score being 76/100 (SD = 25) with 9.2% reporting major bother. For sexual function, the mean score was 29/100 (SD = 26) with 46% reporting major bother. Of the examined variables, age at surgery and surgical volume category were most predictive of function, with disparities exceeding minimally important differences, though large variation was observed between urologists within volume categories. There is considerable variation in 12-month postprostatectomy functional outcomes. Variation is explained by both patient and clinician factors, though some confounders are unmeasured in this cohort.
Competing Interests: Conflict of interest All authors declare no conflicts of interest.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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