Zoledronic acid combined with androgendeprivation therapy may prolong time to castration-resistant prostate cancer in hormone-naı¨ve metastatic prostate cancer patients e A propensity scoring approach

Objective:To clarify the oncological benefit of zoledronic acid for hormone-naive metastatic prostate cancer,patient outcome of androgen deprivation therapy with zoledronic acid(ADT+Z)and androgen deprivation therapy alone(ADT)was compared.Methods:Fifty-two patients with pathologically confirmed metastatic prostate cancer were prospectively enrolled and treated with combined androgen blockade(goserelin and bicalutamide)with zoledronic acid(4 mg every 4 weeks for 24 months).A propensity score-match with logistic regression analysis was applied to select 50 pair-matched cohorts(both from ADT+Z and from historical control cohorts who had undergone ADT alone),and patient outcomes were compared.Results:Patients with ADT+Z had significantly longer time to progression(TTP)than those with ADT(median TTP;24.2 vs.14.0 months,p=0.0092),while no significant difference of overall survival between two groups(p=0.1502).Multivariate analysis for biochemical recurrence revealed treatment with ADT was the sole independent prognostic factor(HR:1.724,95%CI:1.06-2.86,p=0.0297).Conclusion:Combination of zoledronic acid with ADT may prolong time to castration resistant prostate cancer.

Impact of postoperative sexual function on health-related quality of life after robot-assisted radical prostatectomy

Background:We investigated potential disparities in health-related quality of life,particularly concerning urinary function,between patients with preserved and those with impaired sexual function after robot-assisted radical prostatectomy(RARP).Materials and methods:BetweenDecember 2012 and April 2020,704men underwent RARP in our hospital.This study included 155 patients with a preoperative 5-item International Index of Erectile Function(IIEF-5)of≥12 points and an assessable IIEF-5 at 12 months postoperatively.Health-related quality of life was assessed using the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite(EPIC)preoperatively and at 3,6,and 12months postoperatively.A logistic regression analysis andWilcoxon rank sum tests were performed.Results:Patients were grouped according to the median IIEF-5 score 12 months after surgery:those with preserved sexual function(n=71)and those with impaired sexual function(n=84).The mental component summary of the 8-item Short-Form Health Survey was better in the group with preserved sexual function at 6 months postoperatively than in the group with impaired sexual function(p<0.01).In the EPIC,the group with preserved sexual function performed better not only in the sexual domain but also in the urinary domain at all time points comparedwith the groupwith impaired sexual function(p<0.01).In the comparison of the urinary subdomains of the EPIC,there were no significant differences in urinary function or incontinence,but there were significant differences in urinary distress and irritative/obstructive scores(p<0.01).Conclusions:Patients with preserved postoperative sexual function after RARP showed better urinary function than those with impaired sexual function.Hence,preserved sexual function is closely associated with urinary function.