title: Combined reporting of cancer control and functional results of radical prostatectomy.
abstract: BACKGROUND
  The results of radical prostatectomy (cancer control, continence and sexual potency) are currently presented separately, while the success of this surgery depends on a combination of good cancer control with maintenance of continence and erections. We propose a score to jointly evaluate and report cancer control and functional results.
  
  
  METHODS
  The results of 205 radical prostatectomies were studied at one year. Cancer control was evaluated by PSA. Continence and sexual potency were evaluated by a self-administered questionnaire. Each patient was attributed 0 or 4 points according to the presence of absence of biochemical progression (PSA>0.2 ng/ml), 0 or 2 points according to the presence or absence of urinary incontinence (use of pads) and 0 or 1 point according to the presence or absence of impotence (no erections). The sum of these points provided a score classifying the patient into 8 distinct categories, from 0 to 7, each corresponding to a specific status (from 0 (0+0+0): no cancer control-incontinence-impotence to 7 (4+2+1): cancer control-continence-sexual potency).
  
  
  RESULTS
  One year after the operation, 175 (85%) of patients had a PSA less than 0.2 ng/ml, 135 (65.8%) were continent and 64 (32.7%) reported erections. All patients with a score > or =4 had good cancer control, with no functional disorders for a score of 7 (4+2+1) (20%), no disorders of continence for a score of 6 (4+2+0) (31.5%), no disorders of erection for a score of 5 (4+0+1) (8.3%), or with incontinence and impotence for a score of 4 (4+0+0) (21.9%). All patients with a score <4 had a PSA>0.2 ng/ml, but with no functional disorders for a score of 3 (0+2+1) (2.4%), no incontinence for a score of 2 (0+2+0) (8.3%), and no impotence for a score of 1 (0+0+1) (1.9%). 1.9% of patients were incontinent, impotent and showed signs of biochemical progression (score 0=0+0+0).
  
  
  CONCLUSIONS
  This score allows analysis of the global (cancer control and functional) results of radical prostatectomy and would facilitate comparisons between various surgical techniques (type of approach, nerve-sparing techniques) and various centres.
authors.affiliation: Department of Urology, Henri Mondor Hospital, Assistance Publique des Hôpitaux de Paris, EMI 03-37, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Creteil Cedex, France. laurent.salomon@hmn.ap-hop-paris.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Fabien
authors.initials: F
authors.lastname: Saint
authors.forename: Aristotelis G
authors.initials: AG
authors.lastname: Anastasiadis
authors.forename: Philippe
authors.initials: P
authors.lastname: Sebe
authors.forename: Dominique
authors.initials: D
authors.lastname: Chopin
authors.forename: Clément-Claude
authors.initials: CC
authors.lastname: Abbou
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology
chemical_list: D017430:Prostate-Specific Antigen