Construction for the Predictive Model of Quality of Life in Patients After Robot-assisted Radical Prostatectomy: a Cohort Study

Overview

Journal Int J Med Sci

Specialty General Medicine

Date 2024 Dec 4

PMID 39628687

Authors

Yuwei Wu

Jinbao Wang

Xianghong Zhou

Wenjie Zhu

Xingyang Su

Bin Zeng

Shuyi Zhang

Xinyue Liu

Zilong Zhang

Yuming Jin

Jiakun Li

Yimao Sun

Linghui Deng

Lu Yang

Yige Bao

Zhenhua Liu

Qiang Wei

Shi Qiu

Affiliations

Soon will be listed here.

Abstract

Urinary incontinence (UI) and erectile dysfunction (ED) often arise as frequent postoperative complications following robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa). These issues can significantly diminish patients' quality of life (QoL). The assessment of QoL is even more important because treatment decisions may be influenced by the expected QoL. Few studies have integrated the clinical profiles of patients with magnetic resonance imaging (MRI) metrics to assess postoperative UI and ED. PCa patients treated with RARP between January 2018 and September 2022 were enrolled in this study. Preoperative clinical baseline characteristics and MRI parameters were retrospectively collected. The Expanded Prostate Cancer Index Composite Short Form (EPIC-26) questionnaire was completed to assess urinary continence and sexual function at regular postoperative follow-up. Preoperative baseline clinical characteristics and MRI parameters were subsequently used to screen for predictors of urinary continence and sexual function after RARP, and predictive models were constructed. A total of 627 patients with PCa who met the criteria were ultimately included in this study, with 1059 follow-up questionnaires. The predictive model for postoperative urinary continence was constructed with respect to age, history of transurethral resection of the prostate (TURP) surgery, clinical T stage (cT), Gleason score (GS), Charlson score, membranous urethral length (MUL), pubic symphysis-prostate apex length (PAL), urethral width, right anal sphincter thickness and anal levator muscle thickness (axial plane). Moreover, body mass index (BMI), cT, age, GS, Charlson score, internal obturator muscle thickness, urethral width and anal sphincter thickness were predictors of short-term and long-term postoperative sexual function. We were able to develop highly effective predictive models for postoperative urinary continence and sexual function in RARP patients by incorporating baseline clinical features and MRI parameters. The predictive model enables the assessment of postoperative urinary continence and sexual function in patients after RARP and offers clinical guidance.

References

Schmidt S, Garin O, Pardo Y, Valderas J, Alonso J, Rebollo P . Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res. 2014; 23(8):2169-81. PMC: 4155169. DOI: 10.1007/s11136-014-0678-8. View

OCallaghan M, Raymond E, Campbell J, Vincent A, Beckmann K, Roder D . Tools for predicting patient-reported outcomes in prostate cancer patients undergoing radical prostatectomy: a systematic review of prognostic accuracy and validity. Prostate Cancer Prostatic Dis. 2017; 20(4):378-388. DOI: 10.1038/pcan.2017.28. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Gupta N, Singh P, Nayyar R . Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate. BJU Int. 2011; 108(9):1501-5. DOI: 10.1111/j.1464-410X.2011.10113.x. View

Muldoon M, Barger S, Flory J, Manuck S . What are quality of life measurements measuring?. BMJ. 1998; 316(7130):542-5. PMC: 2665651. DOI: 10.1136/bmj.316.7130.542. View

Collette E, Klaver S, Lissenberg-Witte B, van den Ouden D, van Moorselaar R, Vis A . Patient reported outcome measures concerning urinary incontinence after robot assisted radical prostatectomy: development and validation of an online prediction model using clinical parameters, lower urinary tract symptoms and surgical experience. J Robot Surg. 2020; 15(4):593-602. PMC: 8295126. DOI: 10.1007/s11701-020-01145-9. View

Fukui S, Kagebayashi Y, Iemura Y, Matsumura Y, Samma S . Preoperative MRI Parameters Predict Urinary Continence after Robot-Assisted Laparoscopic Prostatectomy in Prostatic Cancer Patients. Diagnostics (Basel). 2019; 9(3). PMC: 6787587. DOI: 10.3390/diagnostics9030102. View

Haskins A, Han P, Lucas F, Bristol I, Hansen M . Development of clinical models for predicting erectile function after localized prostate cancer treatment. Int J Urol. 2014; 21(12):1227-33. DOI: 10.1111/iju.12566. View

Mathew G, Agha R, Albrecht J, Goel P, Mukherjee I, Pai P . STROCSS 2021: Strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. Int J Surg. 2021; 96:106165. DOI: 10.1016/j.ijsu.2021.106165. View

10.

Tienza A, Robles J, Hevia M, Algarra R, Diez-Caballero F, Pascual J . Prevalence analysis of urinary incontinence after radical prostatectomy and influential preoperative factors in a single institution. Aging Male. 2017; 21(1):24-30. DOI: 10.1080/13685538.2017.1369944. View

11.

Hoffman K, Penson D, Zhao Z, Huang L, Conwill R, Laviana A . Patient-Reported Outcomes Through 5 Years for Active Surveillance, Surgery, Brachytherapy, or External Beam Radiation With or Without Androgen Deprivation Therapy for Localized Prostate Cancer. JAMA. 2020; 323(2):149-163. PMC: 6990712. DOI: 10.1001/jama.2019.20675. View

12.

Zhu G, Wen Y, Cao K, He S, Wang T . A review of common statistical methods for dealing with multiple pollutant mixtures and multiple exposures. Front Public Health. 2024; 12:1377685. PMC: 11113012. DOI: 10.3389/fpubh.2024.1377685. View

13.

Ito T, Watanabe K, Matsushita Y, Watanabe H, Tamura K, Motoyama D . Impact of Bladder Neck Angle Measured by Postoperative Magnetic Resonance Imaging on Midterm Recovery of Urinary Continence in Prostate Cancer Patients Undergoing Robot-Assisted Radical Prostatectomy. J Endourol. 2021; 35(11):1610-1615. DOI: 10.1089/end.2021.0071. View

14.

Howard L, Lidbury J, Jeffery N, Washburn S, Patterson C . Evaluation of a flash glucose monitoring system in nondiabetic dogs with rapidly changing blood glucose concentrations. J Vet Intern Med. 2021; 35(6):2628-2635. PMC: 8692193. DOI: 10.1111/jvim.16273. View

15.

Pinkhasov R, Lee T, Huang R, Berkley B, Pinkhasov A, Dodge N . Prediction of Incontinence after Robot-Assisted Radical Prostatectomy: Development and Validation of a 24-Month Incontinence Nomogram. Cancers (Basel). 2022; 14(7). PMC: 8997126. DOI: 10.3390/cancers14071644. View

16.

Parkes J, Slatin S, Pardo S, Ginsberg B . A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose. Diabetes Care. 2000; 23(8):1143-8. DOI: 10.2337/diacare.23.8.1143. View

17.

Jeong S, Yeon J, Lee J, Cha W, Jeong J, Lee B . Development and validation of nomograms to predict the recovery of urinary continence after radical prostatectomy: comparisons between immediate, early, and late continence. World J Urol. 2013; 32(2):437-44. DOI: 10.1007/s00345-013-1127-y. View

18.

Cozzi G, Musi G, Monturano M, Bagnardi V, Frassoni S, Jereczek-Fossa B . Sexual function recovery after robot-assisted radical prostatectomy: Outcomes from an Italian referral centre and predicting nomogram. Andrologia. 2019; 51(10):e13385. DOI: 10.1111/and.13385. View

19.

Schaeffer E, Srinivas S, Adra N, An Y, Barocas D, Bitting R . NCCN Guidelines® Insights: Prostate Cancer, Version 1.2023. J Natl Compr Canc Netw. 2022; 20(12):1288-1298. DOI: 10.6004/jnccn.2022.0063. View

20.

Matsushita K, Kent M, Vickers A, von Bodman C, Bernstein M, Touijer K . Preoperative predictive model of recovery of urinary continence after radical prostatectomy. BJU Int. 2015; 116(4):577-83. PMC: 4768861. DOI: 10.1111/bju.13087. View