Evidence map›Paper›PMID 32736934›Full record

Observational studyUrologic oncology2020

Radiotherapy after radical prostatectomy: Effect of timing of postprostatectomy radiation on functional outcomes.

Heather L Huelster, Aaron A Laviana, Daniel D Joyce, Li-Ching Huang, Zhiguo Zhao, Tatsuki Koyama, Karen E Hoffman, Ralph Conwill, Michael Goodman, Ann S Hamilton and 10 more

Open access · greenAbstract readComparative StudyObservational Study
In one paragraph

Observational study in Urologic oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.1field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Article
  3. International journal of medical sciences · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 11 institutions in 1 country.

Heather L HuelsterDepartment of Urology, Vanderbilt University Medical Center, Nashville, TN.
Aaron A LavianaDepartment of Urology, Vanderbilt University Medical Center, Nashville, TN.
Daniel D JoyceDepartment of Urology, Vanderbilt University Medical Center, Nashville, TN.
Li-Ching HuangDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Zhiguo ZhaoDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Tatsuki KoyamaDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Karen E HoffmanDepartment of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
Ralph ConwillOffice of Patient and Community Education, Patient Advocacy Program, Vanderbilt Ingram Cancer Center, Nashville, TN.
Michael GoodmanDepartment of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA.
Ann S HamiltonDepartment of Preventive Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, CA.
Xiao-Cheng WuDepartment of Epidemiology, Louisiana State University New Orleans School of Public Health, New Orleans, LA.
Lisa E PaddockDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ.
Antoinette StroupDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, NJ.
Matthew CooperbergDepartment of Urology, University of California, San Francisco, CA.
Mia HashibeDepartment of Family and Preventative Medicine, University of Utah School of Medicine, Salt Lake City, UT.
Brock B O'NeilDepartment of Urology, University of Utah Health, Salt Lake City, UT.
Sherrie H KaplanDepartment of Medicine, University of California Irvine, Irvine, CA.
Sheldon GreenfieldDepartment of Medicine, University of California Irvine, Irvine, CA.
David F PensonDepartment of Urology, Vanderbilt University Medical Center, Nashville, TN.
Daniel A BarocasDepartment of Urology, Vanderbilt University Medical Center, Nashville, TN. Electronic address: dan.barocas@vumc.org.
Vanderbilt University Medical Center · USUniversity of California, Irvine · USUniversity of Utah · USEmory University · USLouisiana State University · USRutgers Cancer Institute of New JerseyRutgers, The State University of New Jersey · USThe University of Texas MD Anderson Cancer Center · USUniversity of California, San Francisco · USUniversity of Southern California · USVanderbilt-Ingram Cancer Center

Funding

Comparative Effectiveness of Treatments for Localized Prostate CancerR01HS019356 · AHRQ · VANDERBILT UNIVERSITY · PI PENSON, DAVID F. · 2010 to 2010
$7.6M
Comparative Effectiveness of Modern Therapies for Localized Prostate CancerR01HS022640 · AHRQ · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PENSON, DAVID F. · 2013 to 2013
$1.8M
AHRQ HHS R01 HS019356AHRQ HHS R01 HS022640
6 · The paper itself

Abstract

INTRODUCTION AND

objectiveThe timing of radiotherapy (RT) after prostatectomy is controversial, and its effect on sexual, urinary, and bowel function is unknown. This study seeks to compare patient-reported functional outcomes after radical prostatectomy (RP) and postprostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function.

methodsThe Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based, observational study of men with localized prostate cancer. Patient-reported sexual, urinary, and bowel functional outcomes were measured using the 26-item Expanded Prostate Index Composite at baseline and at 6, 12, 36, and 60 months after enrollment. Functional outcomes were compared among men undergoing RP alone, post-RP adjuvant radiation (RP + aRT), and post-RP salvage radiation (RP + sRT) using multivariable models controlling for baseline clinical, demographic, and functional characteristics.

resultsAmong 1,482 CEASAR participants initially treated with RP for clinically localized prostate cancer, 11.5% (N = 170) received adjuvant (aRT, N = 57) or salvage (sRT, N = 113) radiation. Men who received post-RP RT had worse scores in all domains (sexual function [-9.0, 95% confidence interval {-14.5, -3.6}, P < 0.001], incontinence [-8.8, {-14.0, -3.6}, P < 0.001], irritative voiding [-5.9, {-9.0, -2.8}, P < 0.001], bowel irritative [-3.5, {-5.8, -1.2}, P = 0.002], and hormonal function [-4.5, {-7.2, -1.7}, P = 0.001]) compared to RP alone at 5 years of follow-up. Compared to men treated with RP alone in an adjusted linear model, sRT was associated with significantly worse scores in all functional domains. aRT was associated with significantly worse incontinence, urinary irritation, and hormonal function domain scores compared to RP alone at 5 years of follow-up. On multivariable modeling, RT administered approximately 24 months after RP was associated with the smallest decline in sexual domain score, with an adjusted mean decrease of 8.85 points (95% confidence interval [-19.8, 2.1]) from post-RP, pre-RT baseline.

conclusionsIn men with localized prostate cancer, post-RP RT was associated with significantly worse sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Radiation delayed for approximately 24 months after RP may be optimal for preserving erectile function compared to radiation administered closer to the time of RP.

Indexed as

Patient Reported Outcome MeasuresProstatectomyAgedCombined Modality TherapyHumansMaleMiddle AgedPostoperative PeriodProspective StudiesProstatic NeoplasmsTime FactorsTreatment OutcomeErectile functionOutcomesProstate cancerProstatectomyRadiation

Identifiers

PMID32736934
PMCPMC8095316
OpenAlexW3046151781

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.