Analysis of urological procedures in men who died from prostate cancer using a population-based approach

作者：Babaian Kara; Truong Matthew; Cetnar Jeremy; Cross Deanna S; Shi Fangfang; Ritter Mark A; Jarrard David F^*

来源：BJU International, 2013, 111(3B): E65-E70.

DOI：10.1111/j.1464-410X.2012.11517.x

• prostate cancer
• complications
• urological surgical procedures
• health-related quality of life
• watchful waiting

What's known on the subject? and What does the study add? Very few studies have examined end-of-life urological studies in men with prostate cancer. These studies reported fewer procedures in men who received primary therapy for prostate cancer. However, these studies were typically single institution or had a short follow-up period. The present study is the first population-based study examining end-of-life urological procedures and uses a geographic region encompassing 385000 patients. Furthermore, this study incorporates both hospital- and office-based procedures. This approach has not been previously undertaken. OBJECTIVE center dot To determine using a population-based approach whether men with end-stage prostate cancer who had definitive primary therapy might require fewer urological interventions. Repeated urological procedures can impact health-related quality of life in patients dying from prostate cancer. PATIENTS AND METHODS center dot Using the Marshfield Epidemiological Study Area (MESA) database and tumour registry, we compared end-of-life interventions in men who died from prostate cancer between 1991 and 2009. center dot Patient charts were queried for urological procedures using International Classification of Disease Modification, 9th edition (ICD9) codes for 3 years before death. center dot Clinicopathological information was examined including whether the patient had a history of primary therapy (radiation or radical prostatectomy). RESULTS center dot Among 280 patients dying from prostate cancer, 52 (19%) required 153 urological procedures during the last 3 years of life. The frequency of procedures increased closer to death. The most common procedures involved nephrostomy tube (56%), Foley catheter (24%) and transurethral resection of the prostate (10%). center dot Clinicopathological features did not predict the need for an end-of-life urological procedure. center dot There was no difference in the frequency of upper or lower tract procedures in surgery or radiation patients compared with patients without primary therapy (P= 0.556 and P= 0.508). center dot Using a KaplanMeier analysis, there were no differences between groups in the proportion of patients not requiring a procedure (n= 280; P= 0.179). CONCLUSIONS center dot This is the first population-based study to examine the frequency of urological procedures in patients with end-stage prostate cancer. center dot A minority of patients (19%) required urological procedures during the final 3 years of life. center dot A history of surgery or radiation did not influence the overall risk for urological intervention.

• 出版日期2013-3
• 单位河北医科大学