High incidence of urological complications in men dying from prostate cancer.
BACKGROUND
The incidence and clinical characteristics of urological adverse events suffered by patients with lethal prostate cancer (PCa) toward the end of life are not fully understood.


METHODS
A search of our hospital medical registry identified 3816 individuals diagnosed with PCa, among whom 243 died from the disease and 144 died from other causes (n = 387). We retrospectively reviewed the 387 patients who had died to determine the incidence of PCa-related urological complications, associated factors, and subsequent palliative interventions.


RESULTS
Major urological complications that required therapeutic intervention were observed in 28.4 % of PCa patients dying from the disease itself, whereas such complications were much less frequent (4.3 %) in PCa patients dying from other causes. Urological complications were associated with local recurrence in men who underwent prostatectomy, lower irradiation dose in men who underwent radiotherapy, and pretreatment higher T stage and absence of metastasis in men who underwent androgen deprivation therapy (ADT) as the primary treatment. Patients who received long-term ADT for localized disease had the highest risk for urological complications. Therapeutic intervention was highly effective for palliation.


CONCLUSIONS
Urological adverse events are very common in PCa patients who are dying from the disease. Prevention or early palliation should be considered in patients at high risk of PCa-related urological complications.
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Takashi
T
Kobayashi
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Tomomi
T
Kamba
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Naoki
N
Terada
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Toshinari
T
Yamasaki
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Takahiro
T
Inoue
Department of Urology, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. ogawao@kuhp.kyoto-u.ac.jp.
Osamu
O
Ogawa
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000503:physiopathology; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D014570:Urologic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology
Disease-related complications; Palliative therapy; Prostate cancer