MP45-08 PHOSPHODIESTERASE TYPE 5 INHIBITOR (PDE5I) USE AFTER RADICAL PROSTATECTOMY (RP) IS NOT ASSOCIATED WITH INCREASED RISK OF BIOCHEMICAL RECURRENCE RISK (BCR)

Metabolic syndrome refers to a set of conditions that increases the risk of cardiovascular disease and has been associated with an increased risk of prostate cancer, particularly among African American men. This study aimed to estimate the association of metabolic syndrome with biochemical recurrence (BCR) in a racially diverse population. Among 383 radical prostatectomy patients, 67 patients had documented biochemical recurrence. Hypertension was significantly, positively associated with the rate of BCR (hazard ratio (HR) = 2.1; 95% CI = 1.1, 3.8). There were distinct racial differences in the prevalence of individual metabolic syndrome components; however, the observed associations with BCR did not differ appreciably by race. We conclude that hypertension may contribute to a poorer prognosis in surgically treated prostate cancer patients. Our findings suggest that targeting components of the metabolic syndrome which are potentially modifiable through lifestyle interventions may be a viable strategy to reduce risk of BCR in prostate cancer.

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Phosphodiesterase type 5 inhibitors (PDE5i) and prostate cancer recurrence.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.55 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 55-55

Author(s):

Stacy Loeb ◽

Yasin Folkvaljon ◽

David Robinson ◽

Thorsten Schlomm ◽

Hans Garmo ◽

...

Keyword(s):

Prostate Cancer ◽

Biochemical Recurrence ◽

Conditional Logistic Regression ◽

Population Based ◽

Incidence Density ◽

Cumulative Number ◽

Phosphodiesterase Type 5 Inhibitors ◽

Drug Register ◽

Increased Risk ◽

Phosphodiesterase Type

55 Background: Phosphodiesterase type 5 inhibitors are commonly used for management of erectile dysfunction after prostate cancer (CaP) treatment. Single-institution studies have reported conflicting data on PDE5i use and recurrence after radical prostatectomy (RP). We re-evaluated the association between PDE5i use after RP and RT with biochemical recurrence in a nationwide, population-based registry. Methods: We performed a nested case-control study using data from the National Prostate Cancer Register of Sweden (including >98% prostate cancer cases nationwide), linked to the national Prescribed Drug Register. Among men with localized CaP who underwent primary RT or RP from 2006-2007 with 5 years of follow-up, we identified those with biochemical recurrence (n=293 cases). For each case, we identified 20 controls who were recurrence-free at the event date of the index case, using incidence density sampling stratified by age and treatment (n=5,767 controls). Multivariable conditional logistic regression was used to examine the relationship between overall PDE5i use and cumulative pill number with biochemical recurrence. Results: Among men treated by RT, PDE5i were not associated with BCR (OR 0.97, 95% CI 0.48-1.94), adjusting for marital status, education, income, PSA, clinical stage, Gleason score, and proportion of positive biopsies. As shown in the table, PDE5i were not associated with biochemical recurrence after RP adjusting for clinical features (OR 0.79, 95% CI 0.60-1.05), or with additional adjustment for surgical pathology (OR 0.83, 95% CI 0.62-1.10). Men whose cumulative number of PDE5i pills was above the median had a slightly lower risk of biochemical recurrence in the clinical model, and no difference in risk of biochemical recurrence after adjustment for RP features. Conclusions: Our results from a population-based setting suggest against an increased risk of biochemical recurrence among men using PDE5i after CaP treatment. [Table: see text]

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Penile rehabilitation protocol after robot-assisted radical prostatectomy: assessment of compliance with phosphodiesterase type 5 inhibitor therapy and effect on early potency

BJU International ◽

10.1111/j.1464-410x.2009.08820.x ◽

2010 ◽

Vol 105 (3) ◽

pp. 382-388 ◽

Cited By ~ 23

Author(s):

Daniel J. Lee ◽

Philippa Cheetham ◽

Ketan K. Badani

Keyword(s):

Radical Prostatectomy ◽

Inhibitor Therapy ◽

Robot Assisted ◽

Rehabilitation Protocol ◽

Phosphodiesterase Type 5 Inhibitor ◽

Phosphodiesterase Type ◽

Assessment Of Compliance ◽

Penile Rehabilitation

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Role of Salvage Radical Prostatectomy for Recurrent Prostate Cancer After Radiation Therapy

Journal of Clinical Oncology ◽

10.1200/jco.2005.03.1468 ◽

2005 ◽

Vol 23 (32) ◽

pp. 8198-8203 ◽

Cited By ~ 87

Author(s):

Andrew J. Stephenson ◽

James A. Eastham

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Radical Prostatectomy ◽

Local Recurrence ◽

Salvage Therapy ◽

Biochemical Recurrence ◽

Specific Antigen ◽

Cancer Control ◽

Increased Risk ◽

Salvage Radical Prostatectomy

Patients with isolated local recurrence of prostate cancer after radiation therapy may potentially be cured of their disease by salvage radical prostatectomy (RP). The stage-specific 5-year cancer-control rates of salvage RP resemble those of standard RP. However, the ability to effectively administer salvage treatment to patients with radiorecurrent disease is compromised by the lack of diagnostic tests with sufficient sensitivity and specificity to detect local recurrence at an early stage while it is amenable to local salvage therapy. By the time biochemical recurrence is declared using the current American Society for Therapeutic Radiology and Oncology definition, the majority of patients have advanced local disease, precluding successful local salvage therapy. When salvage RP is performed at prostate-specific antigen levels of 10 ng/mL or less, an estimated 70% of patients are free of disease at 5 years. With better patient selection and technical modifications, the morbidity associated with salvage RP has improved substantially. Rates of urinary incontinence and anastomotic stricture are acceptable, although one third of patients will experience these complications. Salvage cryotherapy is a minimally invasive alternative to salvage RP, but cancer-control rates appear to be inferior and it does not provide a clear advantage over salvage RP in terms of reduced morbidity. Patients with local recurrence after radiation therapy are at increased risk of metastatic progression and cancer-specific mortality. Currently, salvage RP represents the only curative treatment option for these patients. Salvage RP may favorably alter the natural history of biochemical recurrence after radiation therapy, but it must be instituted early in the course of recurrent disease to be effective.

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