Comparative Effectiveness Research in Localized Prostate Cancer: A 10-Year Follow-up Cohort Study

Purpose Long-term comparative effectiveness research on localized prostate cancer treatments is scarce, and evidence lacking especially for brachytherapy. The aim of this study was to assess the long-term impact side effects radical prostatectomy, brachytherapy, external radiation therapy patients with at 10 years, using propensity score analyses. Methods Materials This a prospective observational cohort men who received diagnosis clinically (clinical stage T1 or T2, low intermediate risk group) were treated prostatectomy (n = 139), brachytherapy 317), 194). Treatment decisions jointly made by physicians. Patient-reported outcome (PRO) evaluation included Expanded Prostate Cancer Index Composite Short Form-36, administered centrally telephone interviews before annually after treatment. covers urinary, bowel, sexual, hormonal domains. To PRO changes over time, while accounting correlation among repeated measures, generalized estimating equation models adjusted scores constructed. Results completion rate years 85.8%. Generalized showed that pattern effects, substantial urinary incontinence sexual dysfunction, remained until treatment (standard deviation [SD], –1.1 –1.3, respectively). Brachytherapy produced late deterioration in continence (SD, –0.4) function –0.9) appeared midterm, but differences from statistically significant (P < .001 adjusting score). External similar results bowel bother –0.3). Conclusions Although groups attenuated relevant still years. Our findings support option causes least PROs; it therefore an alternative be considered when making evidence-based