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Long-term adverse effects after curative radiotherapy and radical prostatectomy : population-based nationwide register study

Fridriksson, Jón; Folkvaljon, Yasin; Nilsson, Per LU ; Robinson, David; Franck-Lissbrant, Ingela; Ehdaie, Behfar; Eastham, James A.; Widmark, Anders; Karlsson, Camilla T. and Stattin, Pär (2016) In Scandinavian Journal of Urology2013-01-01+01:00 50(5). p.338-345
Abstract

Objective: The aim of this study was to assess the risk of serious adverse effects after radiotherapy (RT) with curative intention and radical prostatectomy (RP). Materials and methods: Men who were diagnosed with prostate cancer between 1997 and 2012 and underwent curative treatment were selected from the Prostate Cancer data Base Sweden. For each included man, five prostate cancer-free controls, matched for birth year and county of residency, were randomly selected. In total, 12,534 men underwent RT, 24,886 underwent RP and 186,624 were controls. Adverse effects were defined according to surgical and diagnostic codes in the National Patient Registry. The relative risk (RR) of adverse effects up to 12 years after treatment was compared... (More)

Objective: The aim of this study was to assess the risk of serious adverse effects after radiotherapy (RT) with curative intention and radical prostatectomy (RP). Materials and methods: Men who were diagnosed with prostate cancer between 1997 and 2012 and underwent curative treatment were selected from the Prostate Cancer data Base Sweden. For each included man, five prostate cancer-free controls, matched for birth year and county of residency, were randomly selected. In total, 12,534 men underwent RT, 24,886 underwent RP and 186,624 were controls. Adverse effects were defined according to surgical and diagnostic codes in the National Patient Registry. The relative risk (RR) of adverse effects up to 12 years after treatment was compared to controls and the risk was subsequently compared between RT and RP in multivariable analyses. Results: Men with intermediate- and localized high-risk cancer who underwent curative treatment had an increased risk of adverse effects during the full study period compared to controls: the RR of undergoing a procedures after RT was 2.64 [95% confidence interval (CI) 2.56–2.73] and after RP 2.05 (95% CI 2.00–2.10). The risk remained elevated 10–12 years after treatment. For all risk categories of prostate cancer, the risk of surgical procedures for urinary incontinence was higher after RP (RR 23.64, 95% CI 11.71–47.74), whereas risk of other procedures on the lower urinary tract and gastrointestinal tract or abdominal wall was higher after RT (RR 1.67, 95% CI 1.44–1.94, and RR 1.86, 95% CI 1.70–2.02, respectively). Conclusion: The risk of serious adverse effects after curative treatment for prostate cancer remained significantly elevated up to 12 years after treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adverse effects, prostate cancer, radical prostatectomy, radiotherapy
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
50
issue
5
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • scopus:84975463106
  • wos:000384068000003
ISSN
2168-1805
DOI
10.1080/21681805.2016.1194460
language
English
LU publication?
yes
id
0e9a611c-81d1-4514-b70a-fd2a8bc7cf2c
date added to LUP
2016-12-07 14:53:22
date last changed
2017-07-30 05:18:43
@article{0e9a611c-81d1-4514-b70a-fd2a8bc7cf2c,
  abstract     = {<p>Objective: The aim of this study was to assess the risk of serious adverse effects after radiotherapy (RT) with curative intention and radical prostatectomy (RP). Materials and methods: Men who were diagnosed with prostate cancer between 1997 and 2012 and underwent curative treatment were selected from the Prostate Cancer data Base Sweden. For each included man, five prostate cancer-free controls, matched for birth year and county of residency, were randomly selected. In total, 12,534 men underwent RT, 24,886 underwent RP and 186,624 were controls. Adverse effects were defined according to surgical and diagnostic codes in the National Patient Registry. The relative risk (RR) of adverse effects up to 12 years after treatment was compared to controls and the risk was subsequently compared between RT and RP in multivariable analyses. Results: Men with intermediate- and localized high-risk cancer who underwent curative treatment had an increased risk of adverse effects during the full study period compared to controls: the RR of undergoing a procedures after RT was 2.64 [95% confidence interval (CI) 2.56–2.73] and after RP 2.05 (95% CI 2.00–2.10). The risk remained elevated 10–12 years after treatment. For all risk categories of prostate cancer, the risk of surgical procedures for urinary incontinence was higher after RP (RR 23.64, 95% CI 11.71–47.74), whereas risk of other procedures on the lower urinary tract and gastrointestinal tract or abdominal wall was higher after RT (RR 1.67, 95% CI 1.44–1.94, and RR 1.86, 95% CI 1.70–2.02, respectively). Conclusion: The risk of serious adverse effects after curative treatment for prostate cancer remained significantly elevated up to 12 years after treatment.</p>},
  author       = {Fridriksson, Jón and Folkvaljon, Yasin and Nilsson, Per and Robinson, David and Franck-Lissbrant, Ingela and Ehdaie, Behfar and Eastham, James A. and Widmark, Anders and Karlsson, Camilla T. and Stattin, Pär},
  issn         = {2168-1805},
  keyword      = {Adverse effects,prostate cancer,radical prostatectomy,radiotherapy},
  language     = {eng},
  month        = {09},
  number       = {5},
  pages        = {338--345},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Long-term adverse effects after curative radiotherapy and radical prostatectomy : population-based nationwide register study},
  url          = {http://dx.doi.org/10.1080/21681805.2016.1194460},
  volume       = {50},
  year         = {2016},
}