Complications More Likely After Radiotherapy vs. Surgery for PCa

Radiation treatment is associated with an increased risk of requiring minimally invasive urologic procedures.
Radiation treatment is associated with an increased risk of requiring minimally invasive urologic procedures.

Prostate cancer (PCa) patients who undergo radiotherapy have a higher incidence of subsequent minimally invasive urologic procedures for treatment-related complications compared with those who undergo surgery, new data presented at the Canadian Urological Association annual meeting in Ottawa suggest.

Patients treated with radiation also have a higher incidence of rectal-anal procedures and hospital admissions, but they have a lower incidence of major surgical procedures compared with surgery patients, according to findings presented by investigator Christopher J. D. Wallis, MD, of the University of Toronto.

Dr. Wallis and his colleagues used the Surveillance, Epidemiology and End Results (SEER)-Medicare registry to conduct a retrospective cohort study of 60,476 men aged 65–79 years who underwent radical prostatectomy (RP) or radiotherapy (either external beam or brachytherapy) for clinically localized PCa. Of these men, 14,492 underwent primary RP and 45,984 underwent primary radiotherapy. The researchers estimated the incidence of urologic procedures and hospital admissions for complications other than erectile dysfunction or urinary incontinence.

After adjusting for age, ethnicity, marital status, comorbidities, and rural residence, radiotherapy patients had a significant 25% and 40% increased risk of requiring minimally invasive urologic procedures and rectal-anal procedures, respectively, and a significant 80% increased risk of hospital admission compared with RP patients. The radiotherapy patients had a significant 10% decreased risk of requiring major surgical procedures.

The investigators found that the rate of complications in both treatment arms peaked within 2 years of treatment but continued at a steady rate for the next 10 years.

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