Authors: Sugimoto, Mikio; Tsunemori, Hiroyuki; Kakehi, Yoshiyuki

Source: Japanese Journal of Clinical Oncology, Volume 39, Number 10, 4 October 2009 , pp. 671-676(6)

Publisher: Oxford University Press

Abstract:

Objective

Nerve-grafting surgery after resection of neuro-vascular bundles during radical prostatectomy is one of the promising resolutions for dilemma between cancer control and functional preservation. The objective of this study is to evaluate the effect of nerve-grafting surgery on health-related quality of life (HRQOL) in localized prostate cancer patients with special interest in the influence of sexual dysfunction on mental status.

Methods

A total of 88 patients followed for a minimum of 12 months after surgery with a median follow-up of 48 months were enrolled in this study. Of those, 24 patients underwent unilateral nerve-sparing with contralateral nerve-grafting or bilateral nerve-grafting and 64 patients underwent prostatectomy without nerve-sparing procedure. HRQOL assessed with the Japanese version of Extended Prostate Cancer Index Composite (EPIC) and Medical Outcomes Study 8 Items Short Form Health Survey (SF-8) was analyzed cross-sectionally.

Results

Patients in nerve-grafting group who recovered potency demonstrated higher sexual function scores compared with those without nerve-sparing procedure (P 0.022 and 0.001 in 2548 and 49 months or later, respectively). However, sexual bother scores in nerve-grafting group who recovered potency were lower than those without nerve-sparing procedure throughout the observation periods (P 0.012 in 49 months or later).

Conclusions

Cavernous nerve reconstruction provided recovery of erectile dysfunction in substantial proportion of patients, which resulted in favorable physical HRQOL. Majority of these patients, however, did not seem to be satisfied with their sexual function, which caused sustained sexual bother feeling.

Keywords: prostate cancer; radical prostatectomy; quality of life; nerve graft; EPIC

Document Type: Research article

DOI: http://dx.doi.org/10.1093/jjco/hyp082

Publication date: 2009-10-04

More about this publication?

• JJCO was established in 1971 as the first journal from Japan to publish clinical research on cancer in English. It was a biannual journal for the first 11 years, and as the number of submissions increased, it became quarterly in 1983 and bimonthly in 1991. Since 1998, the JJCO has been published monthly.

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