Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer

Background and objective: Our aim was to develop a tool using readily available clinical parameters to predict the probability of poor urinary function following low-dose-rate brachytherapy (LDR-BT) for localized prostate cancer. Methods: Data from the multicentre, prospective Swiss LDR-BT cohort we...

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Main Authors: Gianni Rüedi, Manolis Pratsinis, Hans-Peter Schmid, Sabine Güsewell, Paul M. Putora, Ludwig Plasswilm, Christoph Schwab, Orlando Burkhardt, Armin Thoeni, Werner Hochreiter, Ladislav Prikler, Stefan Suter, Patrick Stucki, Michael Müntener, Nadja Blick, Hans Schiefer, Gautier Müllhaupt, Daniel S. Engeler
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:European Urology Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666168324014265
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author Gianni Rüedi
Manolis Pratsinis
Hans-Peter Schmid
Sabine Güsewell
Paul M. Putora
Ludwig Plasswilm
Christoph Schwab
Orlando Burkhardt
Armin Thoeni
Werner Hochreiter
Ladislav Prikler
Stefan Suter
Patrick Stucki
Michael Müntener
Nadja Blick
Hans Schiefer
Gautier Müllhaupt
Daniel S. Engeler
author_facet Gianni Rüedi
Manolis Pratsinis
Hans-Peter Schmid
Sabine Güsewell
Paul M. Putora
Ludwig Plasswilm
Christoph Schwab
Orlando Burkhardt
Armin Thoeni
Werner Hochreiter
Ladislav Prikler
Stefan Suter
Patrick Stucki
Michael Müntener
Nadja Blick
Hans Schiefer
Gautier Müllhaupt
Daniel S. Engeler
author_sort Gianni Rüedi
collection DOAJ
description Background and objective: Our aim was to develop a tool using readily available clinical parameters to predict the probability of poor urinary function following low-dose-rate brachytherapy (LDR-BT) for localized prostate cancer. Methods: Data from the multicentre, prospective Swiss LDR-BT cohort were analyzed for men treated with LDR-BT. Inclusion criteria were minimum follow-up of 3 yr or postoperative treatment with transurethral resection of the prostate (TURP). A total of 914 men were analyzed, with complete data available for 607 men. Pre-interventional variables assessed were International Prostate Symptom Score (IPSS), prostate volume (PV), maximum urinary flow rate, prostate-specific antigen, postvoid residual urine volume, and age. The primary outcome was poor urinary function after LDR-BT, defined as an IPSS-Quality of Life score >3 (“mostly dissatisfied” or worse) at 3 yr or the occurrence of TURP during follow-up. Associations were evaluated using univariable and multivariable logistic regression. Receiver operating characteristic curve analysis was also performed. Key findings and limitations: Poor urinary function outcomes were observed in 46 patients (5.0%). Significant predictors included pre-interventional IPSS (adjusted odds ratio [aOR] per point 1.18; p < 0.001) and PV (aOR per ml, 1.04; p = 0.004). Limitations of the study include potential selection bias and the absence of external validation. Conclusions and clinical implications: Pre-interventional IPSS and PV were significant predictors of poor urinary function after LDR-BT for prostate cancer. A risk calculator based on these parameters was developed to assist individualized treatment planning. Further studies are needed to validate these findings before they can be applied in routine clinical practice. Patient summary: We created a tool to predict the likelihood of urinary problems after a type of radiotherapy called brachytherapy for prostate cancer. The size of the prostate and urinary symptoms before treatment were associated with poor urinary function after treatment. This tool could help doctors and patients in making informed decisions about treatment for prostate cancer.
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spelling doaj-art-7528bd0658364136b5f89947098c7a462025-01-17T04:52:21ZengElsevierEuropean Urology Open Science2666-16832025-01-01713137Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate CancerGianni Rüedi0Manolis Pratsinis1Hans-Peter Schmid2Sabine Güsewell3Paul M. Putora4Ludwig Plasswilm5Christoph Schwab6Orlando Burkhardt7Armin Thoeni8Werner Hochreiter9Ladislav Prikler10Stefan Suter11Patrick Stucki12Michael Müntener13Nadja Blick14Hans Schiefer15Gautier Müllhaupt16Daniel S. Engeler17Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandDepartment of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland; Corresponding author. Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandClinical Trial Unit, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandDepartment of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland; Department of Radiation Oncology, University of Berne, Berne, SwitzerlandDepartment of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland; Department of Radiation Oncology, University of Berne, Berne, SwitzerlandDepartment of Urology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandDepartment of Urology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandClinic for Radiation-Oncology, Lindenhof Hospital Berne, Berne, SwitzerlandUrology Clinic, Hirslanden Clinic Aarau, Aarau, SwitzerlandUrology Clinic, Uroviva Clinic Buelach, Buelach, SwitzerlandUrologie Zug, Zug, SwitzerlandUrology Clinic, Cantonal Hospital Lucerne, Lucerne, SwitzerlandUrology Clinic, Triemli Hospital, Zurich, SwitzerlandUrology Clinic, Triemli Hospital, Zurich, SwitzerlandDepartment of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandDepartment of Urology, Spital Thun, Thun, SwitzerlandDepartment of Urology, St. Gallen Cantonal Hospital, St. Gallen, SwitzerlandBackground and objective: Our aim was to develop a tool using readily available clinical parameters to predict the probability of poor urinary function following low-dose-rate brachytherapy (LDR-BT) for localized prostate cancer. Methods: Data from the multicentre, prospective Swiss LDR-BT cohort were analyzed for men treated with LDR-BT. Inclusion criteria were minimum follow-up of 3 yr or postoperative treatment with transurethral resection of the prostate (TURP). A total of 914 men were analyzed, with complete data available for 607 men. Pre-interventional variables assessed were International Prostate Symptom Score (IPSS), prostate volume (PV), maximum urinary flow rate, prostate-specific antigen, postvoid residual urine volume, and age. The primary outcome was poor urinary function after LDR-BT, defined as an IPSS-Quality of Life score >3 (“mostly dissatisfied” or worse) at 3 yr or the occurrence of TURP during follow-up. Associations were evaluated using univariable and multivariable logistic regression. Receiver operating characteristic curve analysis was also performed. Key findings and limitations: Poor urinary function outcomes were observed in 46 patients (5.0%). Significant predictors included pre-interventional IPSS (adjusted odds ratio [aOR] per point 1.18; p < 0.001) and PV (aOR per ml, 1.04; p = 0.004). Limitations of the study include potential selection bias and the absence of external validation. Conclusions and clinical implications: Pre-interventional IPSS and PV were significant predictors of poor urinary function after LDR-BT for prostate cancer. A risk calculator based on these parameters was developed to assist individualized treatment planning. Further studies are needed to validate these findings before they can be applied in routine clinical practice. Patient summary: We created a tool to predict the likelihood of urinary problems after a type of radiotherapy called brachytherapy for prostate cancer. The size of the prostate and urinary symptoms before treatment were associated with poor urinary function after treatment. This tool could help doctors and patients in making informed decisions about treatment for prostate cancer.http://www.sciencedirect.com/science/article/pii/S2666168324014265Prostate cancerLow-dose-rate brachytherapyUrinary functionOutcome predictionLower urinary tract symptoms
spellingShingle Gianni Rüedi
Manolis Pratsinis
Hans-Peter Schmid
Sabine Güsewell
Paul M. Putora
Ludwig Plasswilm
Christoph Schwab
Orlando Burkhardt
Armin Thoeni
Werner Hochreiter
Ladislav Prikler
Stefan Suter
Patrick Stucki
Michael Müntener
Nadja Blick
Hans Schiefer
Gautier Müllhaupt
Daniel S. Engeler
Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
European Urology Open Science
Prostate cancer
Low-dose-rate brachytherapy
Urinary function
Outcome prediction
Lower urinary tract symptoms
title Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
title_full Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
title_fullStr Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
title_full_unstemmed Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
title_short Predicting Urinary Function Outcomes Following Low-dose-rate Brachytherapy for Prostate Cancer
title_sort predicting urinary function outcomes following low dose rate brachytherapy for prostate cancer
topic Prostate cancer
Low-dose-rate brachytherapy
Urinary function
Outcome prediction
Lower urinary tract symptoms
url http://www.sciencedirect.com/science/article/pii/S2666168324014265
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