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Radiotherapy after radical prostatectomy worsens sexual, urinary function

Key clinical point: In patients with localized prostate cancer, radiotherapy (RT) after radical prostatectomy (RP) is associated with significantly worse sexual, urinary, and bowel functions vs. RP alone at 5 years of follow-up.

Major finding: Patients who received post-RP RT had worse scores in all domains regardless of the timing of receiving RT (sexual function [−9.0 point difference in the 26-item Expanded Prostate Index Composite score; P less than .001], incontinence [−8.8; P less than .001], irritative voiding [−5.9; P less than .001], bowel irritative [−3.5; P = .002], and hormonal function [−4.5; P = .001]) vs. RP alone at 5 years of follow-up.

Study details: This study included 1,482 patients initially treated with RP for clinically localized prostate cancer (11.5% [n = 170] received adjuvant [n = 57] or salvage [n = 113] radiation) using data from the prospective, population-based Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) cohort.

Disclosures: CEASAR is supported by the National Cancer Institute, Agency for Healthcare Research and Quality, and the Patient-Centered Outcomes Research Institute. The authors declared no conflicts of interest.


Huelster HL et al. Urol Oncol. 2020 Jul 29. doi: 10.1016/j.urolonc.2020.06.022.