Timing of Post-RP Radiotherapy Does Not Affect Complication Rate

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MONTREAL—The timing of radiation therapy (RT) after radical prostatectomy (RP) for prostate cancer does not affect the rate of urinary incontinence, bladder neck contracture, and urethral stricture long term, according to researchers.

A team at the University of Toronto led by Sidney B. Radomski, MD, reviewed the outcomes of 652 patients who underwent RP. Of these, 162 (24.8%) received early radiation treatment postoperatively (within six months of surgery) and 490 (75.2%) received late radiation treatment (six months or more after surgery). The mean time to early RT and late RT was 3.6 and 30.1 months, respectively.

Of the early RT patients, 88 (54.3%) had urinary incontinence after RP. Of these, 42 (25.9%), 30 (18.5%), and 27 (16.7%) were incontinent at one, two, and three years, respectively, after surgery, the researchers reported at the Canadian Urological Association annual meeting. Of the late RT patients, 170 (34.7%) had urinary incontinence postoperatively. Of these, 95 (19.4%), 82 (16.7%), and 72 (14.7%) had incontinence at one, two, and three years, respectively, after surgery.

Bladder neck contracture developed postoperatively in 27 (4%) of the 652 patients. Urethral stricture developed in 10 (1.5%). One patient experienced both complications. At three years post-RT, bladder neck contracture resolved in 23 of the 27 patients. One case persisted. The status of the remaining three cases was not known. Urethral stricture resolved in six of the 10 patients. The status of the remaining four cases was not known. The study revealed no significant difference in the rates of urinary incontinence, bladder neck contracture, and urethral stricture between the early and late RT groups.

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