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Albers LF, Tillier CN, van Muilekom E, van Werkhoven E, Elzevier HW, van Rhijn BWG, van der Poel HG, Hendricksen K. Sexual Satisfaction in Men Suffering From Erectile Dysfunction After Robot-Assisted Radical Prostatectomy for Prostate Cancer: An Observational Study. J Sex Med 2020; 18:339-346. [PMID: 33358558 DOI: 10.1016/j.jsxm.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/05/2020] [Accepted: 11/20/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Preservation of erectile function is an important postoperative quality of life concern for patients after robot-assisted radical prostatectomy (RARP) for prostate cancer. Although erectile function may recover, many men continue to suffer from erectile dysfunction (ED). AIM This study aims to determine whether satisfaction with sexual life improves in patients with ED after RARP and which factors are associated with satisfaction during follow-up. METHODS A review was carried out of a prospectively maintained database of patients with prostate cancer who underwent a RARP between 2006 and 2019. The "International Index of Erectile Function" questionnaire was used to describe ED (range 5-25), overall satisfaction with sexual life and sexual desire (range for both: 2-10). Patients with ED due to RARP were compared with those without ED after RARP. Mixed effect model was used to test differences in satisfaction over time. Mann-Whitney U tests and multiple logistic regression were used to assess factors associated with being satisfied at 24 and 36 months. OUTCOMES The main outcomes of this study are the overall satisfaction with sexual life score over time and factors which influence sexual satisfaction. RESULTS Data of 2808 patients were reviewed. Patients whose erectile function was not known (n = 643) or who had ED at the baseline (n = 1281) were excluded. About 884 patients were included for analysis. They had an overall satisfaction score of 8.4. Patients with ED due to RARP had mean overall satisfaction scores of 4.8, 4.8, 4.9, and 4.6 at 6 mo, 12 mo, 24 mo, and 36 mo. These scores were significantly lower than those of patients without ED at every time point. In multiple regression analysis, higher overall satisfaction score at the baseline and higher sexual desire at 24 and 36 months' follow-up were associated with satisfaction with sexual life at 24 and 36 months' follow-up. No association was found for erectile function. CLINICAL IMPLICATIONS Interventions focusing on adjustment to the changes in sexual functioning might improve sexual satisfaction; especially for those men who continue to suffer from ED. STRENGTHS & LIMITATIONS Strengths of this study are the large number of patients, time of follow-up, and use of multiple validated questionnaires. Our results must be interpreted within the limits of retrospectively collected, observational data. CONCLUSION Satisfaction with sexual life in men with ED due to RARP may take a long time to improve. One could counsel patients that sexual satisfaction is based on individual baseline sexual satisfaction and the return of sexual desire after RARP. Albers LF, Tillier CN, van Muilekom HAM, et al. Sexual Satisfaction in Men Suffering From Erectile Dysfunction After Robot-Assisted Radical Prostatectomy for Prostate Cancer: An Observational Study. J Sex Med 2021;18:339-346.
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Affiliation(s)
- Leonore F Albers
- Department of Urology and Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Corinne N Tillier
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Erik van Muilekom
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Erik van Werkhoven
- Biometrics Department, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Henk W Elzevier
- Department of Urology and Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Bas W G van Rhijn
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, Caritas St Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Henk G van der Poel
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Kees Hendricksen
- Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Drudge-Coates L, van Muilekom E, de la Torre-Montero JC, Leonard K, van Oostwaard M, Niepel D, Jensen BT. Management of bone health in patients with cancer: a survey of specialist nurses. Support Care Cancer 2020; 28:1151-1162. [PMID: 31203509 PMCID: PMC6989658 DOI: 10.1007/s00520-019-04858-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/09/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with cancer can experience bone metastases and/or cancer treatment-induced bone loss (CTIBL), and the resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients through better management of their bone health, which may improve quality of life and survival. METHODS An anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of support in the management of bone metastases and CTIBL. RESULTS Of 283 participants, most stated that they worked in Europe, and 69.3% had at least 8 years of experience in oncology. The most common areas of specialisation were medical oncology, breast cancer and/or palliative care (20.8-50.9%). Awareness of bone loss prevention measures varied (from 34.3% for alcohol intake to 77.4% for adequate calcium intake), and awareness of hip fracture risk factors varied (from 28.6% for rheumatoid arthritis to 74.6% for age > 65 years). Approximately one-third reported a high level of confidence in managing bone metastases (39.9%) and CTIBL (33.2%). International or institution guidelines were used by approximately 50% of participants. Common barriers to better specialist care and treatment were reported to be lack of training, funding, knowledge or professional development. CONCLUSION This work is the first quantitative analysis of reports from specialist oncology nurses about the management of bone metastases and CTIBL. It indicates the need for new nursing education initiatives with a focus on bone health management.
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Affiliation(s)
- Lawrence Drudge-Coates
- Department of Urology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
| | - Erik van Muilekom
- Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, Netherlands
| | | | - Kay Leonard
- St Luke's Radiation Oncology Centre at St James's Hospital, Dublin, Ireland
| | | | | | - Bente Thoft Jensen
- Aarhus University Hospital and Centre of Research in Rehabilitation, Aarhus University, Aarhus, Denmark
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Hinsenveld FJ, Wit EM, van Leeuwen PJ, Brouwer OR, Donswijk ML, Tillier CN, Vegt E, van Muilekom E, van Oosterom MN, van Leeuwen FW, van der Poel HG. Prostate-Specific Membrane Antigen PET/CT Combined with Sentinel Node Biopsy for Primary Lymph Node Staging in Prostate Cancer. J Nucl Med 2019; 61:540-545. [DOI: 10.2967/jnumed.119.232199] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022] Open
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Grivas N, de Bruin D, Barwari K, van Muilekom E, Tillier C, van Leeuwen PJ, Wit E, Kroese W, van der Poel H. Ultrasensitive prostate-specific antigen level as a predictor of biochemical progression after robot-assisted radical prostatectomy: Towards risk adapted follow-up. J Clin Lab Anal 2018; 33:e22693. [PMID: 30365194 DOI: 10.1002/jcla.22693] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/18/2018] [Accepted: 09/21/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Ultrasensitive prostate-specific antigen (USPSA) is useful for stratifying patients according to their USPSA-based risk. Aim of our study was to determine the usefulness of USPSA as predictor of biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP). METHODS This retrospective study included 213 prostate cancer patients who had a postoperative USPSA between 0.01 and 0.2 ng/mL and at least 2 years of follow-up. We developed predictive models for BCR with PSA ≥0.2 and ≥0.5 ng/mL. RESULTS A total of 103 patients (48.3%) had BCR at a median follow-up of 13.3 months. Higher postoperative USPSA (odds ratio [OR] = 4.73, P < 0.01), bilateral positive surgical margin in both sides (OR = 1.32, P = 0.044), higher average PSA rise (OR = 1.67, P = 0.031), ISUP grade group ≥3 (OR = 1.48, P = 0.003), and shorter interval since RARP (OR = 0.58, P < 0.001) were independent predictors of BCR with PSA ≥0.2 ng/mL. Higher postoperative USPSA (OR = 3.85, P < 0.01), bilateral positive surgical margin (OR = 1.34, P = 0.011), ISUP grade group ≥3 (OR = 1.5, P = 0.002), and shorter interval since RARP (OR = 0.61, P = 0.001) were independent predictors of BCR with PSA ≥0.5 ng/mL. The areas under the curve for the first and second model were 0.865 and 0.834, respectively. CONCLUSION Ultrasensitive PSA after RARP is a useful prognostic indicator of BCR which could guide postoperative risk stratification and layout follow-up scheduling.
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Affiliation(s)
- Nikolaos Grivas
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Kurdo Barwari
- Department of Urology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Erik van Muilekom
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Corinne Tillier
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Pim J van Leeuwen
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Esther Wit
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Henk van der Poel
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Grivas N, van der Roest R, Tillier C, Schouten D, van Muilekom E, Schoots I, van der Poel H, Heijmink S. Patterns of Benign Prostate Hyperplasia Based on Magnetic Resonance Imaging Are Correlated With Lower Urinary Tract Symptoms and Continence in Men Undergoing a Robot-assisted Radical Prostatectomy for Prostate Cancer. Urology 2017; 107:196-201. [PMID: 28601562 DOI: 10.1016/j.urology.2017.05.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/24/2017] [Accepted: 05/30/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the association between benign prostatic hyperplasia (BPH) patterns, classified by magnetic resonance imaging (MRI), with lower urinary tract symptoms (LUTS) or continence, preoperatively and after robot-assisted laparoscopic radical prostatectomy (RARP). MATERIALS AND METHODS This retrospective study included 49 prostate cancer patients, with prostate size >47 cm3, who underwent an endorectal MRI followed by RARP. Five BPH patterns were identified according to Wasserman, and additional prostate measurements were recorded. LUTS were assessed using the International Prostate Symptom Score and the PR25-LUTS-Questionnaire score. Continence was assessed using the International Consultation of Incontinence Questionnaire-Short Form. RESULTS BPH pattern 3 (44.9%) was identified most common, followed by pattern 5 (26.6%), 1 (24.5%), and 2 and 4 (both 2%). BPH patterns were significant predictors of preoperative LUTS, with pedunculated with bilateral transition zone (TZ) and retrourethral enlargement (pattern 5) causing more severe symptoms compared with bilateral TZ and retrourethral enlargement (pattern 3) and bilateral TZ enlargement (pattern 1), whereas pattern 3 was additionally associated with more voiding symptoms compared with pattern 1. None of the BPH patterns was predictive of postoperative LUTS and continence. Independent predictors of continence at 12 months were lower preoperative PR25-LUTS score (P = .022) and longer membranous urethral length (P = .025). CONCLUSION MRI is useful for classifying patients in BPH patterns which are strongly associated with preoperative LUTS. However, BPH patterns did not predict remnant LUTS or postoperative incontinence. Postoperative continence status was only associated with preoperative LUTS and membranous urethra length.
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Affiliation(s)
- Nikolaos Grivas
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - Rosanne van der Roest
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Corinne Tillier
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Daan Schouten
- Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Erik van Muilekom
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ivo Schoots
- Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk van der Poel
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Stijn Heijmink
- Department of Radiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Valdagni R, Van Poppel H, Aitchison M, Albers P, Berthold D, Bossi A, Brausi M, Denis L, Drudge-Coates L, De Santis M, Feick G, Harrison C, Haustermans K, Hollywood D, Hoyer M, Hummel H, Mason M, Mirone V, Müller SC, Parker C, Saghatchian M, Sternberg CN, Tombal B, van Muilekom E, Watson M, Wesselmann S, Wiegel T, Magnani T, Costa A. Prostate Cancer Unit Initiative in Europe: A position paper by the European School of Oncology. Crit Rev Oncol Hematol 2015; 95:133-43. [PMID: 26092320 DOI: 10.1016/j.critrevonc.2015.05.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/04/2015] [Accepted: 05/26/2015] [Indexed: 02/06/2023] Open
Abstract
The Prostate Cancer Programme of the European School of Oncology developed the concept of specialised interdisciplinary and multiprofessional prostate cancer care to be formalized in Prostate Cancer Units (PCU). After the publication in 2011 of the collaborative article "The Requirements of a Specialist Prostate Cancer Unit: A Discussion Paper from the European School of Oncology", in 2012 the PCU Initiative in Europe was launched. A multiprofessional Task Force of internationally recognized opinion leaders, among whom representatives of scientific societies, and patient advocates gathered to set standards for quality comprehensive prostate cancer care and designate care pathways in PCUs. The result was a consensus on 40 mandatory and recommended standards and items, covering several macro-areas, from general requirements to personnel to organization and case management. This position paper describes the relevant, feasible and applicable core criteria for defining PCUs in most European countries delivered by PCU Initiative in Europe Task Force.
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Affiliation(s)
- Riccardo Valdagni
- European School of Oncology, Milan, Italy; Prostate Cancer Programme, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Hendrik Van Poppel
- Dept of Urology, University Hospital of the Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Peter Albers
- Dept of Urology, Heinrich Heine University Hospital, Düsseldorf, Germany
| | - Dominik Berthold
- Centre Polidisciplinaire d'Oncologie, Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alberto Bossi
- Dept of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Maurizio Brausi
- Dept of Urology, Ausl Modena, Nuovo Ospedale Civile-S. Agostino Estense, Modena, Italy
| | - Louis Denis
- Europa Uomo, Antwerp, Belgium; Oncological Centre, Antwerp, Belgium
| | | | - Maria De Santis
- University of Warwick, Cancer Research Unit, Coventry, UK; Queen Elizabeth Hospital-Cancer Centre, Birmingham, UK
| | - Günther Feick
- Europa Uomo, Antwerp, Belgium; Bundesverband Prostatakrebs Selbsthilfe, Bonn, Germany
| | - Chris Harrison
- Greater Manchester Strategic Health Authority, Manchester, UK
| | - Karin Haustermans
- Dept. of Radiation Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Donal Hollywood
- Urologic and Radiation Oncology, Institute of Molecular Medicine, Trinity College Dublin, Dublin, Ireland
| | - Morton Hoyer
- Dept of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Henk Hummel
- Integraal Kankercentrum Nederland (IKNL), Comprehensive Cancer Centre Netherlands, Utrecht, The Netherlands
| | - Malcolm Mason
- Dept of Oncology and Palliative Medicine, Cardiff University School of Medicine, Velindre Hospital, Cardiff, UK
| | - Vincenzo Mirone
- Dept of Urology, University of Naples Federico II, Naples, Italy
| | | | - Chris Parker
- Academic Urology Unit, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | | | - Cora N Sternberg
- Dept of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy
| | - Bertrand Tombal
- Dept of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Erik van Muilekom
- Dept of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maggie Watson
- Research Department of Clinical, Educational and Health Psychology, University College, London, UK
| | | | - Thomas Wiegel
- Dept of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - Tiziana Magnani
- Prostate Cancer Programme, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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van Muilekom E, Grube B, Kelly D. European Oncology Nursing Society (EONS) at 30: Much has been achieved, but there is still more to do. Eur J Oncol Nurs 2014; 18:547-8. [DOI: 10.1016/j.ejon.2014.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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van Muilekom E. Letter of Welcome. Eur J Oncol Nurs 2014. [DOI: 10.1016/s1462-3889(14)70005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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van den Bergh RCN, de Blok W, van Muilekom E, Tillier C, Venderbos LD, van der Poel HG. Impact on quality of life of radical prostatectomy after initial active surveillance: more to lose? Scand J Urol 2014; 48:367-73. [DOI: 10.3109/21681805.2013.876097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Acar C, Schoffelmeer CC, Tillier C, de Blok W, van Muilekom E, van der Poel HG. Quality of life in patients with low-risk prostate cancer. A comparative retrospective study: brachytherapy versus robot-assisted laparoscopic prostatectomy versus active surveillance. J Endourol 2013; 28:117-24. [PMID: 23978277 DOI: 10.1089/end.2013.0349] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To investigate the quality of life (QoL) after different treatment modalities for low-risk prostate cancer, including brachytherapy, robot-assisted laparoscopic prostatectomy (RALP), and active surveillance (AS) with validated questionnaires. MATERIALS AND METHODS From a prospective database, we selected a total of 144 men with low-grade localized prostate cancer including 65 (45.1%) patients with RALP, 29 (20.2%) with brachytherapy, and 50 (34.7%) whose cancer was managed with AS. QoL was routinely evaluated with validated questionnaires: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30), EORTC-QLQ-Prostate Module (PR)25, International Index of Erectile Function (IIEF)-15, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with a minimum follow-up of 1 year. RESULTS In comparison with baseline scores, the brachytherapy group showed a significant decrease of QoL domain scores of voiding complaints (P=0.010), use of incontinence aids (P=0.011), sexual functioning domain (P=0.011), and erectile function (P≤0.001). In the RALP group, sexual function (P≤0.001), incontinence (P≤0.001), and erectile function were significantly affected. A decrease in sexual function was observed in 71% of men after RALP and 59% after brachytherapy. In 30% of men under AS, a decrease of erectile function score during follow-up was reported. Overall, no significant decrease in general QoL was observed neither for men under AS nor for men treated by brachytherapy or RALP. Clinical factors such as age, prostate size, prostate-specific antigen level, and nerve preservation during RALP were nonpredictive of overall QoL after treatment for the individual patient (P=0.676). CONCLUSION Patients with low-risk prostate cancer who are treated with brachytherapy or RALP report deterioration of QoL of specific domains such as voiding, continence, and sexual functioning in comparison with AS patients. A decrease of erectile function was also observed during AS. Overall QoL was similar for all three treatments options.
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Affiliation(s)
- Cenk Acar
- 1 Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital , Amsterdam, The Netherlands
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Sonnek FC, Muilekom EV. Metastatic castration-resistant prostate cancer. Part 2: helping patients make informed choices and managing treatment side effects. Eur J Oncol Nurs 2013; 17 Suppl 1:S7-12. [DOI: 10.1016/s1462-3889(14)70003-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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van Muilekom E. How does ONS Congress help educate Dutch oncology nurses? ONS Connect 2013; 28:25. [PMID: 23808067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Erik van Muilekom
- Netherlands Cancer Institute--Antoni van Leeuwenhoek Hospital in Amsterdam
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Bul M, Zhu X, Valdagni R, Pickles T, Kakehi Y, Rannikko A, Bjartell A, van der Schoot DK, Cornel EB, Conti GN, Boevé ER, Staerman F, Vis-Maters JJ, Vergunst H, Jaspars JJ, Strölin P, van Muilekom E, Schröder FH, Bangma CH, Roobol MJ. Active surveillance for low-risk prostate cancer worldwide: the PRIAS study. Eur Urol 2012; 63:597-603. [PMID: 23159452 DOI: 10.1016/j.eururo.2012.11.005] [Citation(s) in RCA: 389] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 11/04/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Overdiagnosis and subsequent overtreatment are important side effects of screening for, and early detection of, prostate cancer (PCa). Active surveillance (AS) is of growing interest as an alternative to radical treatment of low-risk PCa. OBJECTIVE To update our experience in the largest worldwide prospective AS cohort. DESIGN, SETTING, AND PARTICIPANTS Eligible patients had clinical stage T1/T2 PCa, prostate-specific antigen (PSA) ≤ 10 ng/ml, PSA density <0.2 ng/ml per milliliter, one or two positive biopsy cores, and Gleason score ≤ 6. PSA was measured every 3-6 mo, and volume-based repeat biopsies were scheduled after 1, 4, and 7 yr. Reclassification was defined as more than two positive cores or Gleason >6 at repeat biopsy. Recommendation for treatment was triggered in case of PSA doubling time <3 yr or reclassification. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariate regression analysis was used to evaluate predictors for reclassification at repeat biopsy. Active therapy-free survival (ATFS) was assessed with a Kaplan-Meier analysis, and Cox regression was used to evaluate the association of clinical characteristics with active therapy over time. RESULTS AND LIMITATIONS In total, 2494 patients were included and followed for a median of 1.6 yr. One or more repeat biopsies were performed in 1480 men, of whom 415 men (28%) showed reclassification. Compliance with the first repeat biopsy was estimated to be 81%. During follow-up, 527 patients (21.1%) underwent active therapy. ATFS at 2 yr was 77.3%. The strongest predictors for reclassification and switching to deferred treatment were the number of positive cores (two cores compared with one core) and PSA density. The disease-specific survival rate was 100%. Follow-up was too short to draw definitive conclusions about the safety of AS. CONCLUSIONS Our short-term data support AS as a feasible strategy to reduce overtreatment. Clinical characteristics and PSA kinetics during follow-up can be used for risk stratification. Strict monitoring is even more essential in men with high-risk features to enable timely recognition of potentially aggressive disease and offer curative intervention. Limitations of using surrogate end points and markers in AS should be recognized. TRIAL REGISTRATION The current program is registered at the Dutch Trial Register with ID NTR1718 (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1718).
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Affiliation(s)
- Meelan Bul
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
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van der Poel HG, Tillier C, de Blok W, van Muilekom E. Extended Nodal Dissection Reduces Sexual Function Recovery After Robot-Assisted Laparoscopic Prostatectomy. J Endourol 2012; 26:1192-8. [DOI: 10.1089/end.2012.0011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Corinne Tillier
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Willem de Blok
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Erik van Muilekom
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Joshi N, de Blok W, van Muilekom E, van der Poel H. Impact of posterior musculofascial reconstruction on early continence after robot-assisted laparoscopic radical prostatectomy: results of a prospective parallel group trial. Eur Urol 2010; 58:84-9. [PMID: 20362386 DOI: 10.1016/j.eururo.2010.03.028] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 03/15/2010] [Indexed: 11/15/2022]
Abstract
BACKGROUND A significant proportion of patients develop urinary incontinence early after radical prostatectomy. Posterior reconstruction of supporting tissues has been found to reduce incontinence in open and conventional laparoscopic prostatectomy series. OBJECTIVE To investigate whether our version of a posterior musculofascial reconstruction will reduce early incontinence and have a beneficial effect on patients' quality of life (QoL). DESIGN, SETTING, AND PARTICIPANTS One hundred seven consecutive patients undergoing primary robot-assisted radical laparoscopic prostatectomy (RALP) performed by a single surgeon at one tertiary referral oncology institution were alternately assigned (not randomised) to intervention (n=53) or control groups (n=54). SURGICAL PROCEDURE RALP with median fibrous raphe reconstruction (MFRR) followed by formation of the urethrovesical anastomosis (intervention group) versus standard anastomosis without posterior reconstruction (control group). MEASUREMENTS Measurements included incontinence at baseline and 3-mo intervals; QoL as measured by a simple questionnaire, the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life-Core 30 (QLQ-C30), and Prostate Cancer Module (PR25) questionnaires preoperatively and at 6 mo postprocedure; tumour characteristics; operative time; fascial preservation score; duration of catheterisation; and anastomotic leakage on cystogram. RESULTS AND LIMITATIONS For intervention and control groups respectively, mean catheter duration was 11.74 d and 12.74 d (p=0.451); leakage on cystogram was present in six and eight cases (p=0.28); and incontinence (any involuntary urine loss) at 3 mo was 75% and 69% (p=0.391) and at 6 mo was 51% and 43% (p=0.686). Urinary retention occurred only in one case (control group). The percentage of cases returning to baseline in all QoL domains (except insomnia) was similar at 6 mo between the two groups. Short follow-up, lack of blinding, and probable small differences in our method of MFRR performed compared with other studies were identified as significant limitations. CONCLUSIONS No significant difference in any of the analysed outcome measures was observed. Posterior reconstruction of the musculofascial complex does not appear to improve early urinary incontinence after RALP.
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Affiliation(s)
- Neil Joshi
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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