title: Comparative study of inguinal hernia repair rates after radical prostatectomy or external beam radiotherapy.
abstract: OBJECTIVE
  We tested the hypothesis that patients treated for localized prostate cancer with radical prostatectomy (RP) have a higher risk of requiring an inguinal hernia (IH) repair than their counterparts treated with external beam radiotherapy (EBRT).
  
  
  METHODS
  Within the Quebec Health Plan database, we identified 6,422 men treated with RP and 4,685 men treated with EBRT for localized prostate cancer between 1990 and 2000, in addition to 6,933 control patients who underwent a prostate biopsy. From among that population, we identified patients who underwent a unilateral or bilateral hernia repair after either RP or EBRT. Kaplan-Meier plots showed IH repair-free survival rates. Univariable and multivariable Cox regression models tested the predictors of IH repair after RP or EBRT. Covariates consisted of age, year of surgery, and Charlson Comorbidity Index.
  
  
  RESULTS
  IH repair-free survival rates at 1, 2, 5, and 10 years were 96.8, 94.3, 90.5, and 86.2% vs. 98.9, 98.0, 95.4, and 92.2%, respectively, in RP vs. EBRT patients (log-rank test, p < 0.001). IH repair-free survival rates in the biopsy population were 98.3, 97.1, 94.9, and 90.2% at the same four time points. In multivariable Cox regression models, RP predisposed to a 2.3-fold higher risk of IH repair than EBRT (p < 0.001). Besides therapy type, patient age (p < 0.001) represented the only other independent predictor of IH repair.
  
  
  CONCLUSIONS
  RP predisposes to a higher rate of IH repair relative to EBRT. This observation should be considered at informed consent.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.forename: Maxine
authors.initials: M
authors.lastname: Sun
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alasker
authors.forename: Claudio
authors.initials: C
authors.lastname: Jeldres
authors.forename: Hendrik
authors.initials: H
authors.lastname: Isbarn
authors.forename: Lars
authors.initials: L
authors.lastname: Budäus
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Lattouf
authors.forename: Luc
authors.initials: L
authors.lastname: Valiquette
authors.forename: Francois
authors.initials: F
authors.lastname: Bénard
authors.forename: Fred
authors.initials: F
authors.lastname: Saad
authors.forename: Markus
authors.initials: M
authors.lastname: Graefen
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000401:mortality; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D006552:Hernia, Inguinal / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D011792:Quebec; D011878:Radiotherapy / Q000706:statistics & numerical data