title: Association between long-term erectile dysfunction and biochemical recurrence after permanent seed I(125) implant brachytherapy for prostate cancer. A longitudinal study of a single-institution.
abstract: We aimed to investigate the predictive factor of erectile dysfunction (ED) in prostate cancer (PCa) patients who underwent low-dose permanent I(125) seed implant brachytherapy and to investigate if ED could represent a patient's reported outcome measures (PROMs) of efficacy of BT and indirectly associated with biochemical recurrence free survival (BRFS). From 2000 to 2012, 176 consecutive patients with low-risk PCa underwent BT. ED was evaluated with the International Index of Erectile Function (IIEF-5). Cox regression analysis was performed to assess significant predictors of mild-to-severe ED and BRFS after BT, including covariates. The 10-year actuarial rate of ED was 66%. Subjects with severe ED had higher values of D90 (183.0 versus 177.0; p < 0.05) and V100% (40.1 versus 31.4; p < 0.05) compared with normal. At the multivariate logistic regression analysis, D90 (OR: 1.10; p < 0.05) was an independent predictor of ED. Multivariate Cox-regression analysis did not demonstrate significant association between erectile preservation and biochemical recurrence (BCR) after 10 years of follow up (HR: 2.15; p = 0.20), while D90 ≤ 180 Gy independently predicted BCR (HR: 4.65; [95%CI: 1.25-17.34]; p < 0.05). Erectile preservation should be addressed as valuable PROMs after permanent seed I(125) implant, but it is not associated with better BRFS.
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Castelli
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Privitera
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Chaled
authors.initials: C
authors.lastname: Al-Nakib
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Favilla
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Marchese
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.affiliation: a Department of Urology , University of Catania , Catania , Italy.
authors.forename: Giorgio Ivan
authors.initials: GI
authors.lastname: Russo
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*
chemical_list: D007457:Iodine Radioisotopes
keywords: Biochemical recurrence; Erectile dysfunction; IIEF-5; brachytherapy; outcomes; prostate cancer; risk factors