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MP46-19 detailing sexual outcomes after focal therapy for localised prostate cancer: a systematic review and meta-analysis

Fiard, Gaelle, Chowdhury, Aminah, Potter, Aneirin, Pook, Celina, Kelly, Daniel ORCID: https://orcid.org/0000-0002-1847-0655, Emberton, Mark and Yap, Tet 2021. MP46-19 detailing sexual outcomes after focal therapy for localised prostate cancer: a systematic review and meta-analysis. The Journal of Urology 206 (Supple) , e821-e821. 10.1097/JU.0000000000002067.19

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Abstract

INTRODUCTION AND OBJECTIVE: Focal therapy has emerged as a promising option to treat well-selected men with localised prostate cancer while preserving healthy prostate tissue and key structures, such as the urethral sphincter and neurovascular bundles. However, how this tissue preservation may translate into improved outcomes, particularly into improved sexual outcomes, is still an active research field. We conducted a systematic review and meta-analysis of the literature to summarise the existing evidence in order to provide patients with updated data on what to expect after treatment, and help identify gaps in current knowledge that may warrant future research. METHODS: A systematic literature search was conducted on Medline, EMBASE, Scopus and Web of Science. The search strategy was defined using the ‘litsearchr’ function in R based on a preliminary “naïve” search using the following terms on Medline: ((“focal therapy” OR “focal treatment”) AND (“prostate cancer”) AND (“sexual function” OR “erectile function”)). A total of 37 studies, comprising 2573 patients treated and 1992 with available sexual outcomes were included in the data synthesis. RESULTS: HIFU (n=856, 43%) and cryotherapy (n=404, 20%) accounted for the highest number of patients analysed, while irreversible electroporation (n=137, 7%) was the least studied technique. The 5 item International Index of Erectile Function (IIEF-5) was the most frequently used questionnaire (26/37 studies), with completion rates ranging from 24-100% at 18-24 months. A significant decrease in IIEF-5 scores was noted at 3 months with an improvement at 6 and 12 months (Figure). Patients with an altered baseline sexual function were more likely to experience a significant postoperative decrease in erectile function scores. Continence rates (no pad use) ranged from 87.5 to 100%. Radical treatment rates ranged from 1.7% to 20.8%. The patient-reported outcomes (PRO) questionnaires used were not designed for a diverse population. CONCLUSIONS: Focal therapy led to changes in erectile function in most cases under the significance threshold of the patient-reported outcomes questionnaires used. Patients should be counseled according to their baseline erectile function. More research is warranted to detail aspects other than erectile function.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Publisher: Lippincott, Williams & Wilkins
ISSN: 0022-5347
Last Modified: 09 Nov 2022 11:28
URI: https://orca.cardiff.ac.uk/id/eprint/143415

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