ArticleEuropean urology open science2025
Twenty-year Patient-reported Outcomes After Surgery, Radiotherapy, or Brachytherapy for Localized Prostate Cancer.
Article in European urology open science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01492751 (Effectiveness of Three Primary Treatments for Localized Prostate Cancer), which is not on this map. Not yet cited in PubMed.
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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.
The trial behind it
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Effectiveness of Three Primary Treatments for Localized Prostate Cancer: Radical Prostatectomy, External-beam Radiotherapy, and Prostate Brachytherapy
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18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and objective: Our objective was to compare the impact of open radical prostatectomy (RP), external beam radiotherapy (EBRT), and brachytherapy in patients with localized prostate cancer via patient-reported outcome measures up to 20 yr after treatment. Methods: This was a prospective observational study (ClinicalTrials.gov NCT01492751) of men with localized prostate cancer (clinical stage T1-T2, low or intermediate risk). The Expanded Prostate Cancer Index Composite (EPIC-26) and Short Form-36 (SF-36) questionnaires were centrally administered via telephone interviews before treatment and then annually after treatment. Generalized estimating equation models were constructed with propensity score-based weights. Key findings and limitations: The RP group reported gradual, statistically significant worsening for almost all EPIC-26 and SF-36 scores at most follow-up time points. Significantly lower urinary incontinence deterioration was observed in both radiotherapy groups than after RP. Urinary irritative/obstructive, sexual, bowel, and hormonal symptom patterns were similar regardless of treatment, except for less sexual deterioration in the brachytherapy group. The observational design is the main limitation, but propensity score weights mitigated treatment selection bias. Conclusions and clinical implications: Our findings provide detailed novel evidence, measured over 20 yr, on the long-term impact of disease and treatment on patients with localized prostate cancer. While all treatment groups showed a general deterioration over time, important differences in urinary incontinence (highest after RP) and sexual decline (least after brachytherapy) persisted at 20 yr, and these should be incorporated into shared decision-making processes. Patient summary: Our study provides new findings on outcomes of treatment for localized prostate cancer as reported by patients over a period of up to 20 years. There was a general deterioration over time, but worse urinary incontinence after radical prostatectomy and the lowest decline in sexual function after brachytherapy persisted over time. These findings can inform patients during shared decision-making on the most suitable treatment for localized prostate cancer.
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