Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study
Summary Background Studies of complications resulting from surgery or radiotherapy for prostate cancer have mainly focused on incontinence and erectile dysfunction. We aimed to assess other important complications associated with these treatments for prostate cancer. Methods We did a population-base...
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| Veröffentlicht in: | The lancet oncology 2014-02, Vol.15 (2), p.223-231 |
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| creator | Nam, Robert K, Prof Cheung, Patrick, MD Herschorn, Sender, Prof Saskin, Refik, MSc Su, Jiandong, MSc Klotz, Laurence H, Prof Chang, Michelle, MD Kulkarni, Girish S, MD Lee, Yuna, MD Kodama, Ronald T, Prof Narod, Steven A, Prof |
| description | Summary Background Studies of complications resulting from surgery or radiotherapy for prostate cancer have mainly focused on incontinence and erectile dysfunction. We aimed to assess other important complications associated with these treatments for prostate cancer. Methods We did a population-based retrospective cohort study, in which we used administrative hospital data, physician billing codes, and cancer registry data for men who underwent either surgery or radiotherapy alone for prostate cancer between 2002 and 2009 in Ontario, Canada. We measured the 5-year cumulative incidence of five treatment-related complication endpoints: hospital admissions; urological, rectal, or anal procedures; open surgical procedures; and secondary malignancies. Findings In the 32 465 patients included in the study, the 5-year cumulative incidence of admission to hospital for a treatment-related complication was 22·2% (95% CI 21·7–22·7), but was 2·4% (2·2–2·6) for patients whose length of stay was longer than 1 day. The 5-year cumulative incidence of needing a urological procedure was 32·0% (95% CI 31·4–32·5), that of a rectal or anal procedure was 13·7% (13·3–14·1), and that of an open surgical procedure was 0·9% (0·8–1·1). The 5-year cumulative incidence of a second primary malignancy was 3·0% (2·6–3·5). These risks were significantly higher than were those of 32 465 matched controls with no history of prostate cancer. Older age and comorbidity at the time of index treatment were important predictors for a complication in all outcome categories, but the type of treatment received was the strongest predictor for complications. Patients who were given radiotherapy had higher incidence of complications for hospital admissions, rectal or anal procedures, open surgical procedures, and secondary malignancies at 5 years than did those who underwent surgery (adjusted hazard ratios 2·08–10·8, p |
| doi_str_mv | 10.1016/S1470-2045(13)70606-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1751229258</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1470204513706065</els_id><sourcerecordid>1751227833</sourcerecordid><originalsourceid>FETCH-LOGICAL-c580t-bd0b4bf7c519a1a72bbe4bb84b532e958028e853ad77d5bfbe5e63f57d5d613e3</originalsourceid><addsrcrecordid>eNqNkstu1TAURSMEoqXwCSBLTMog4Od1LoMiVPGoVIkBMLb8OFFdcu1gO0j5Ln4QJ2lB6qSM_Fp7-9hnN81zgl8TTHZvvhIucUsxF6eEvZJ4h3eteNAc123eCt51D9f5hhw1T3K-xphIgsXj5ohyznEFj5vfF8F6B8ECij2y8TAO3uriY8golitIqFzpgKbkg04z8sHGUHzYBAlBAlv8AMjNuZ-CXYRI96XqknbVaUBjirnoUrl4mBfNcrBa63FGfd24JZDV1Ta9RRqNcZyGtYzW6AyuVnYVU0G5TG5-2jzq9ZDh2c140nz_-OHb-ef28suni_P3l60VHS6tcdhw00sryF4TLakxwI3puBGMwr4ytINOMO2kdML0BgTsWC_qwu0IA3bSnG6-tcCfE-SiDj5bGAYdIE5ZESkIpXsquv9EZcfY_SjfM7mXnPKKvryDXscphfrmhaJYCMxxpcRG2fqPOUGvxuQPtVuKYLVkRa1ZUUsQFGFqzYoSVffixn0yB3B_VbfhqMC7DYD6yb88JJWtXzrv_NJ25aK_94qzOw528GGJxQ-YIf97jcpU4c1k8SBsdRDsD64-5y0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1492055040</pqid></control><display><type>article</type><title>Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Nam, Robert K, Prof ; Cheung, Patrick, MD ; Herschorn, Sender, Prof ; Saskin, Refik, MSc ; Su, Jiandong, MSc ; Klotz, Laurence H, Prof ; Chang, Michelle, MD ; Kulkarni, Girish S, MD ; Lee, Yuna, MD ; Kodama, Ronald T, Prof ; Narod, Steven A, Prof</creator><creatorcontrib>Nam, Robert K, Prof ; Cheung, Patrick, MD ; Herschorn, Sender, Prof ; Saskin, Refik, MSc ; Su, Jiandong, MSc ; Klotz, Laurence H, Prof ; Chang, Michelle, MD ; Kulkarni, Girish S, MD ; Lee, Yuna, MD ; Kodama, Ronald T, Prof ; Narod, Steven A, Prof</creatorcontrib><description>Summary Background Studies of complications resulting from surgery or radiotherapy for prostate cancer have mainly focused on incontinence and erectile dysfunction. We aimed to assess other important complications associated with these treatments for prostate cancer. Methods We did a population-based retrospective cohort study, in which we used administrative hospital data, physician billing codes, and cancer registry data for men who underwent either surgery or radiotherapy alone for prostate cancer between 2002 and 2009 in Ontario, Canada. We measured the 5-year cumulative incidence of five treatment-related complication endpoints: hospital admissions; urological, rectal, or anal procedures; open surgical procedures; and secondary malignancies. Findings In the 32 465 patients included in the study, the 5-year cumulative incidence of admission to hospital for a treatment-related complication was 22·2% (95% CI 21·7–22·7), but was 2·4% (2·2–2·6) for patients whose length of stay was longer than 1 day. The 5-year cumulative incidence of needing a urological procedure was 32·0% (95% CI 31·4–32·5), that of a rectal or anal procedure was 13·7% (13·3–14·1), and that of an open surgical procedure was 0·9% (0·8–1·1). The 5-year cumulative incidence of a second primary malignancy was 3·0% (2·6–3·5). These risks were significantly higher than were those of 32 465 matched controls with no history of prostate cancer. Older age and comorbidity at the time of index treatment were important predictors for a complication in all outcome categories, but the type of treatment received was the strongest predictor for complications. Patients who were given radiotherapy had higher incidence of complications for hospital admissions, rectal or anal procedures, open surgical procedures, and secondary malignancies at 5 years than did those who underwent surgery (adjusted hazard ratios 2·08–10·8, p<0·0001). However, the number of urological procedures was lower in the radiotherapy than in the surgery group (adjusted hazard ratio 0·66, 95% CI 0·63–0·69; p<0·0001) Interpretation Complications after prostate cancer treatment are frequent and dependent on age, comorbidity, and the type of treatment. Patients and physicians should be aware of these risks when choosing treatment for prostate cancer, and should balance them with the clinical effectiveness of each therapy. Funding Ajmera Family Chair in Urologic Oncology.</description><identifier>ISSN: 1470-2045</identifier><identifier>EISSN: 1474-5488</identifier><identifier>DOI: 10.1016/S1470-2045(13)70606-5</identifier><identifier>PMID: 24440474</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Erectile Dysfunction - epidemiology ; Health insurance ; Hematology, Oncology and Palliative Medicine ; Hospitals ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Men ; Middle Aged ; Neoplasms, Second Primary - epidemiology ; Ontario - epidemiology ; Patient Readmission ; Postoperative Complications - diagnosis ; Postoperative Complications - etiology ; Postoperative Complications - therapy ; Proportional Hazards Models ; Prostate cancer ; Prostatectomy - adverse effects ; Prostatic Neoplasms - epidemiology ; Prostatic Neoplasms - radiotherapy ; Prostatic Neoplasms - surgery ; Radiation therapy ; Radiotherapy - adverse effects ; Registries ; Reoperation ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Urinary Incontinence - epidemiology</subject><ispartof>The lancet oncology, 2014-02, Vol.15 (2), p.223-231</ispartof><rights>Elsevier Ltd</rights><rights>2014 Elsevier Ltd</rights><rights>Copyright © 2014 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c580t-bd0b4bf7c519a1a72bbe4bb84b532e958028e853ad77d5bfbe5e63f57d5d613e3</citedby><cites>FETCH-LOGICAL-c580t-bd0b4bf7c519a1a72bbe4bb84b532e958028e853ad77d5bfbe5e63f57d5d613e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1470204513706065$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24440474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nam, Robert K, Prof</creatorcontrib><creatorcontrib>Cheung, Patrick, MD</creatorcontrib><creatorcontrib>Herschorn, Sender, Prof</creatorcontrib><creatorcontrib>Saskin, Refik, MSc</creatorcontrib><creatorcontrib>Su, Jiandong, MSc</creatorcontrib><creatorcontrib>Klotz, Laurence H, Prof</creatorcontrib><creatorcontrib>Chang, Michelle, MD</creatorcontrib><creatorcontrib>Kulkarni, Girish S, MD</creatorcontrib><creatorcontrib>Lee, Yuna, MD</creatorcontrib><creatorcontrib>Kodama, Ronald T, Prof</creatorcontrib><creatorcontrib>Narod, Steven A, Prof</creatorcontrib><title>Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study</title><title>The lancet oncology</title><addtitle>Lancet Oncol</addtitle><description>Summary Background Studies of complications resulting from surgery or radiotherapy for prostate cancer have mainly focused on incontinence and erectile dysfunction. We aimed to assess other important complications associated with these treatments for prostate cancer. Methods We did a population-based retrospective cohort study, in which we used administrative hospital data, physician billing codes, and cancer registry data for men who underwent either surgery or radiotherapy alone for prostate cancer between 2002 and 2009 in Ontario, Canada. We measured the 5-year cumulative incidence of five treatment-related complication endpoints: hospital admissions; urological, rectal, or anal procedures; open surgical procedures; and secondary malignancies. Findings In the 32 465 patients included in the study, the 5-year cumulative incidence of admission to hospital for a treatment-related complication was 22·2% (95% CI 21·7–22·7), but was 2·4% (2·2–2·6) for patients whose length of stay was longer than 1 day. The 5-year cumulative incidence of needing a urological procedure was 32·0% (95% CI 31·4–32·5), that of a rectal or anal procedure was 13·7% (13·3–14·1), and that of an open surgical procedure was 0·9% (0·8–1·1). The 5-year cumulative incidence of a second primary malignancy was 3·0% (2·6–3·5). These risks were significantly higher than were those of 32 465 matched controls with no history of prostate cancer. Older age and comorbidity at the time of index treatment were important predictors for a complication in all outcome categories, but the type of treatment received was the strongest predictor for complications. Patients who were given radiotherapy had higher incidence of complications for hospital admissions, rectal or anal procedures, open surgical procedures, and secondary malignancies at 5 years than did those who underwent surgery (adjusted hazard ratios 2·08–10·8, p<0·0001). However, the number of urological procedures was lower in the radiotherapy than in the surgery group (adjusted hazard ratio 0·66, 95% CI 0·63–0·69; p<0·0001) Interpretation Complications after prostate cancer treatment are frequent and dependent on age, comorbidity, and the type of treatment. Patients and physicians should be aware of these risks when choosing treatment for prostate cancer, and should balance them with the clinical effectiveness of each therapy. Funding Ajmera Family Chair in Urologic Oncology.</description><subject>Aged</subject><subject>Erectile Dysfunction - epidemiology</subject><subject>Health insurance</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Ontario - epidemiology</subject><subject>Patient Readmission</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - therapy</subject><subject>Proportional Hazards Models</subject><subject>Prostate cancer</subject><subject>Prostatectomy - adverse effects</subject><subject>Prostatic Neoplasms - epidemiology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Radiation therapy</subject><subject>Radiotherapy - adverse effects</subject><subject>Registries</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Urinary Incontinence - epidemiology</subject><issn>1470-2045</issn><issn>1474-5488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkstu1TAURSMEoqXwCSBLTMog4Od1LoMiVPGoVIkBMLb8OFFdcu1gO0j5Ln4QJ2lB6qSM_Fp7-9hnN81zgl8TTHZvvhIucUsxF6eEvZJ4h3eteNAc123eCt51D9f5hhw1T3K-xphIgsXj5ohyznEFj5vfF8F6B8ECij2y8TAO3uriY8golitIqFzpgKbkg04z8sHGUHzYBAlBAlv8AMjNuZ-CXYRI96XqknbVaUBjirnoUrl4mBfNcrBa63FGfd24JZDV1Ta9RRqNcZyGtYzW6AyuVnYVU0G5TG5-2jzq9ZDh2c140nz_-OHb-ef28suni_P3l60VHS6tcdhw00sryF4TLakxwI3puBGMwr4ytINOMO2kdML0BgTsWC_qwu0IA3bSnG6-tcCfE-SiDj5bGAYdIE5ZESkIpXsquv9EZcfY_SjfM7mXnPKKvryDXscphfrmhaJYCMxxpcRG2fqPOUGvxuQPtVuKYLVkRa1ZUUsQFGFqzYoSVffixn0yB3B_VbfhqMC7DYD6yb88JJWtXzrv_NJ25aK_94qzOw528GGJxQ-YIf97jcpU4c1k8SBsdRDsD64-5y0</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Nam, Robert K, Prof</creator><creator>Cheung, Patrick, MD</creator><creator>Herschorn, Sender, Prof</creator><creator>Saskin, Refik, MSc</creator><creator>Su, Jiandong, MSc</creator><creator>Klotz, Laurence H, Prof</creator><creator>Chang, Michelle, MD</creator><creator>Kulkarni, Girish S, MD</creator><creator>Lee, Yuna, MD</creator><creator>Kodama, Ronald T, Prof</creator><creator>Narod, Steven A, Prof</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140201</creationdate><title>Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study</title><author>Nam, Robert K, Prof ; Cheung, Patrick, MD ; Herschorn, Sender, Prof ; Saskin, Refik, MSc ; Su, Jiandong, MSc ; Klotz, Laurence H, Prof ; Chang, Michelle, MD ; Kulkarni, Girish S, MD ; Lee, Yuna, MD ; Kodama, Ronald T, Prof ; Narod, Steven A, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c580t-bd0b4bf7c519a1a72bbe4bb84b532e958028e853ad77d5bfbe5e63f57d5d613e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Erectile Dysfunction - epidemiology</topic><topic>Health insurance</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Ontario - epidemiology</topic><topic>Patient Readmission</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - therapy</topic><topic>Proportional Hazards Models</topic><topic>Prostate cancer</topic><topic>Prostatectomy - adverse effects</topic><topic>Prostatic Neoplasms - epidemiology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Radiation therapy</topic><topic>Radiotherapy - adverse effects</topic><topic>Registries</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Urinary Incontinence - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nam, Robert K, Prof</creatorcontrib><creatorcontrib>Cheung, Patrick, MD</creatorcontrib><creatorcontrib>Herschorn, Sender, Prof</creatorcontrib><creatorcontrib>Saskin, Refik, MSc</creatorcontrib><creatorcontrib>Su, Jiandong, MSc</creatorcontrib><creatorcontrib>Klotz, Laurence H, Prof</creatorcontrib><creatorcontrib>Chang, Michelle, MD</creatorcontrib><creatorcontrib>Kulkarni, Girish S, MD</creatorcontrib><creatorcontrib>Lee, Yuna, MD</creatorcontrib><creatorcontrib>Kodama, Ronald T, Prof</creatorcontrib><creatorcontrib>Narod, Steven A, Prof</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Lancet Titles</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>The lancet oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nam, Robert K, Prof</au><au>Cheung, Patrick, MD</au><au>Herschorn, Sender, Prof</au><au>Saskin, Refik, MSc</au><au>Su, Jiandong, MSc</au><au>Klotz, Laurence H, Prof</au><au>Chang, Michelle, MD</au><au>Kulkarni, Girish S, MD</au><au>Lee, Yuna, MD</au><au>Kodama, Ronald T, Prof</au><au>Narod, Steven A, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study</atitle><jtitle>The lancet oncology</jtitle><addtitle>Lancet Oncol</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>15</volume><issue>2</issue><spage>223</spage><epage>231</epage><pages>223-231</pages><issn>1470-2045</issn><eissn>1474-5488</eissn><coden>LANCAO</coden><abstract>Summary Background Studies of complications resulting from surgery or radiotherapy for prostate cancer have mainly focused on incontinence and erectile dysfunction. We aimed to assess other important complications associated with these treatments for prostate cancer. Methods We did a population-based retrospective cohort study, in which we used administrative hospital data, physician billing codes, and cancer registry data for men who underwent either surgery or radiotherapy alone for prostate cancer between 2002 and 2009 in Ontario, Canada. We measured the 5-year cumulative incidence of five treatment-related complication endpoints: hospital admissions; urological, rectal, or anal procedures; open surgical procedures; and secondary malignancies. Findings In the 32 465 patients included in the study, the 5-year cumulative incidence of admission to hospital for a treatment-related complication was 22·2% (95% CI 21·7–22·7), but was 2·4% (2·2–2·6) for patients whose length of stay was longer than 1 day. The 5-year cumulative incidence of needing a urological procedure was 32·0% (95% CI 31·4–32·5), that of a rectal or anal procedure was 13·7% (13·3–14·1), and that of an open surgical procedure was 0·9% (0·8–1·1). The 5-year cumulative incidence of a second primary malignancy was 3·0% (2·6–3·5). These risks were significantly higher than were those of 32 465 matched controls with no history of prostate cancer. Older age and comorbidity at the time of index treatment were important predictors for a complication in all outcome categories, but the type of treatment received was the strongest predictor for complications. Patients who were given radiotherapy had higher incidence of complications for hospital admissions, rectal or anal procedures, open surgical procedures, and secondary malignancies at 5 years than did those who underwent surgery (adjusted hazard ratios 2·08–10·8, p<0·0001). However, the number of urological procedures was lower in the radiotherapy than in the surgery group (adjusted hazard ratio 0·66, 95% CI 0·63–0·69; p<0·0001) Interpretation Complications after prostate cancer treatment are frequent and dependent on age, comorbidity, and the type of treatment. Patients and physicians should be aware of these risks when choosing treatment for prostate cancer, and should balance them with the clinical effectiveness of each therapy. Funding Ajmera Family Chair in Urologic Oncology.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>24440474</pmid><doi>10.1016/S1470-2045(13)70606-5</doi><tpages>9</tpages></addata></record> |
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| ispartof | The lancet oncology, 2014-02, Vol.15 (2), p.223-231 |
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| subjects | Aged Erectile Dysfunction - epidemiology Health insurance Hematology, Oncology and Palliative Medicine Hospitals Humans Incidence Kaplan-Meier Estimate Male Men Middle Aged Neoplasms, Second Primary - epidemiology Ontario - epidemiology Patient Readmission Postoperative Complications - diagnosis Postoperative Complications - etiology Postoperative Complications - therapy Proportional Hazards Models Prostate cancer Prostatectomy - adverse effects Prostatic Neoplasms - epidemiology Prostatic Neoplasms - radiotherapy Prostatic Neoplasms - surgery Radiation therapy Radiotherapy - adverse effects Registries Reoperation Retrospective Studies Risk Factors Time Factors Treatment Outcome Urinary Incontinence - epidemiology |
| title | Incidence of complications other than urinary incontinence or erectile dysfunction after radical prostatectomy or radiotherapy for prostate cancer: a population-based cohort study |
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