Quality of life after brachytherapy or bilateral nerve‐sparing robot‐assisted radical prostatectomy for prostate cancer: a prospective cohort

Abstract

This prospective non-randomized study shows long-term differences in QoL domains after bilateral nerve-sparing RARP and brachytherapy. Differences in patient satisfaction should be further explored. These results could be used to counsel patients in the decision-making process.

Brachytherapy: An overview for clinicians

“…LDR brachytherapy is considered as an option for patients who have favorable intermediate‐risk disease (Gleason 7, prostate‐specific antigen <10 ng/mL; or Gleason 6, prostate‐specific antigen 10‐20 ng/mL) . The technique has several advantages over other options: compared with radical prostatectomy, it is a simple and minimally invasive technique that can be performed as an outpatient procedure under spinal anesthesia with rapid recovery and a lower incidence of dribbling . Prostate HDR brachytherapy can be also performed over a few sessions consisting of inserting catheters within the gland using high‐activity radioactive sources of iridium‐192.…”

Quality of life outcomes after low dose‐rate brachytherapy for localized prostate cancer: Current status and future perspectives

“…These results imply the disadvantage of EBRT in the bowel domain compared with BT. According to a report by Blanchard et al ., nerve‐sparing RARP showed superior QOL with respect to bowel symptoms at 12 and 24 months compared with BT, although this difference gradually declined as follow up approached 48 months . According to the above‐mentioned SPIRIT, there was no difference between the two groups in SF‐12 and PCSI for bowel domains over time periods of up to 48 months.…”

“…This tendency did not change with nerve‐sparing RARP. In the report of Blanchard et al ., adjusted by propensity score match analysis with respect to QOL, BT and nerve‐sparing RARP were shown to be significantly superior in the sexual domain at 12 and 24 months …”

“…Regarding these recent advances in surgical methods, Blanchard et al . carried out a prospective non‐randomized study comparing HRQOL evaluated by EPIC for 181 patients who received BT and 210 patients who underwent RARP . Notably, of the patients who underwent RARP, 178 received the BNS procedure.…”

Editorial Comment to Quality of life after external beam radiotherapy for localized prostate cancer: Comparison with other modalities

“…Nowadays, patients have many options for radiation therapies, and some patients prefer radiation therapies compared with surgery because of the prevention of adverse events, such as urinary incontinence or sexual function. Recent studies compared the post‐treatment QOL between brachytherapy and bilateral nerve‐sparing robotic‐assisted radical prostatectomy (RARP) for prostate cancer from their 6‐year cases . They showed that those patients with brachytherapy experienced significantly less effect on sexual function and urinary continence.…”