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Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "Trifecta"?
Int Braz J Urol. 2011 May-Jun; 37(3):320-7; discussion 327.IB

Abstract

PURPOSE

The desirable outcomes after open radical prostatectomy (RP) for localized prostate cancer (PC) are to: a) achieve disease recurrence free, b) urinary continence (UC), and c) maintain sexual potency (SP). These 3 combined desirable outcomes we called it the "Trifecta". Our aim is to assess the likelihood of achieving the Trifecta, and to analyze the influencing the Trifecta.

MATERIALS AND METHODS

A total of 1738 men with localized PC underwent RP from 1992-2007 by a single surgeon. The exclusion criteria for this analysis were: preoperative hormonal or radiation therapy, preoperative urinary incontinence or erectile dysfunction, follow-up less than 24 months or insufficient data. Post-operative Trifecta factors were analyzed, including biochemical recurrence (BR). We defined: BR as PSA ≥ 0.2 ng/mL, urinary continence as wearing no pads, and sexual potency as having erections sufficient for intercourse with or without a phosphodiesterase-5 inhibitor.

RESULTS

A total of 831 patients met the inclusion criteria. The mean age of the entire cohort was 59 years old. The median follow-up was 52 months (mean 60, range 24-202). The BR, UC and SP rates were 18.7%, 94.5%, and 71% respectively. Trifecta was achieved in 64% at 2 year follow-up, and 61% at 5 year follow-up. Multivariate analysis revealed age at time of surgery, pathologic Gleason score (PGS), pathologic stage, specimen weight, and nerve sparing (NS) were independent factors.

CONCLUSIONS

Age at time of surgery, pathologic GS, pathologic stage, specimen weight and NS were independent predictors to achieve the Trifecta following radical prostatectomy. This information may help patients counseling undergoing radical prostatectomy for localized prostate cancer.

Authors+Show Affiliations

Department of Urology, Miller School of Medicine, University of Miami, Miami, FL 33101, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21756379

Citation

Antebi, Elie, et al. "Oncological and Functional Outcomes Following Open Radical Prostatectomy: How Patients May Achieve the "Trifecta"?" International Braz J Urol : Official Journal of the Brazilian Society of Urology, vol. 37, no. 3, 2011, pp. 320-7; discussion 327.
Antebi E, Eldefrawy A, Katkoori D, et al. Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "Trifecta"? Int Braz J Urol. 2011;37(3):320-7; discussion 327.
Antebi, E., Eldefrawy, A., Katkoori, D., Soloway, C. T., Manoharan, M., & Soloway, M. S. (2011). Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "Trifecta"? International Braz J Urol : Official Journal of the Brazilian Society of Urology, 37(3), 320-7; discussion 327.
Antebi E, et al. Oncological and Functional Outcomes Following Open Radical Prostatectomy: How Patients May Achieve the "Trifecta". Int Braz J Urol. 2011 May-Jun;37(3):320-7; discussion 327. PubMed PMID: 21756379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "Trifecta"? AU - Antebi,Elie, AU - Eldefrawy,Ahmed, AU - Katkoori,Devendar, AU - Soloway,Cynthia T, AU - Manoharan,Murugesan, AU - Soloway,Mark S, PY - 2010/07/30/accepted PY - 2011/7/16/entrez PY - 2011/7/16/pubmed PY - 2011/12/13/medline SP - 320-7; discussion 327 JF - International braz j urol : official journal of the Brazilian Society of Urology JO - Int Braz J Urol VL - 37 IS - 3 N2 - PURPOSE: The desirable outcomes after open radical prostatectomy (RP) for localized prostate cancer (PC) are to: a) achieve disease recurrence free, b) urinary continence (UC), and c) maintain sexual potency (SP). These 3 combined desirable outcomes we called it the "Trifecta". Our aim is to assess the likelihood of achieving the Trifecta, and to analyze the influencing the Trifecta. MATERIALS AND METHODS: A total of 1738 men with localized PC underwent RP from 1992-2007 by a single surgeon. The exclusion criteria for this analysis were: preoperative hormonal or radiation therapy, preoperative urinary incontinence or erectile dysfunction, follow-up less than 24 months or insufficient data. Post-operative Trifecta factors were analyzed, including biochemical recurrence (BR). We defined: BR as PSA ≥ 0.2 ng/mL, urinary continence as wearing no pads, and sexual potency as having erections sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS: A total of 831 patients met the inclusion criteria. The mean age of the entire cohort was 59 years old. The median follow-up was 52 months (mean 60, range 24-202). The BR, UC and SP rates were 18.7%, 94.5%, and 71% respectively. Trifecta was achieved in 64% at 2 year follow-up, and 61% at 5 year follow-up. Multivariate analysis revealed age at time of surgery, pathologic Gleason score (PGS), pathologic stage, specimen weight, and nerve sparing (NS) were independent factors. CONCLUSIONS: Age at time of surgery, pathologic GS, pathologic stage, specimen weight and NS were independent predictors to achieve the Trifecta following radical prostatectomy. This information may help patients counseling undergoing radical prostatectomy for localized prostate cancer. SN - 1677-6119 UR - https://www.unboundmedicine.com/medline/citation/21756379/Oncological_and_functional_outcomes_following_open_radical_prostatectomy:_how_patients_may_achieve_the_"Trifecta" L2 - http://www.brazjurol.com.br/may_june_2011/Antebi_320_327.htm DB - PRIME DP - Unbound Medicine ER -