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首页> 外文期刊>The journal of sexual medicine >Association between Preoperative Erectile Dysfunction and Prostate Cancer Features-An Analysis from the Duke Prostate Center Database
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Association between Preoperative Erectile Dysfunction and Prostate Cancer Features-An Analysis from the Duke Prostate Center Database

机译：术前勃起功能障碍与前列腺癌特征之间的关联-来自杜克大学前列腺中心数据库的分析

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Introduction. Erectile dysfunction (ED) is related to several co-morbidities including obesity, metabolic syndrome, cigarette smoking, and low testosterone, all of which have been reported to be associated with adverse prostate cancer features. Aim. To examine whether preoperative ED has a relationship with adverse prostate cancer features in patients who underwent radical prostatectomy (RP). Methods. We analyzed data from our institution on 676 patients who underwent RP between 2001 and 2010. Crude and adjusted logistic regression models were used to investigate the association between preoperative ED and several pathological parameters. The log-rank test and multivariate proportional hazards model were conducted to determine the association of preoperative ED with biochemical recurrence (BCR). Main Outcome Measures. The Expanded Prostate Cancer Index Composite (EPIC) instrument was used to evaluate preoperative erectile function (EF). Preoperative normal EF was defined as EPIC-SF≥60 points while ED was defined as preoperative EPIC-SF lower than 60 points. Results. Preoperatively, a total of 343 (50.7%) men had normal EF and 333 (49.3%) men had ED. After adjusting for covariates, preoperative ED was identified a risk factor for positive extracapsular extension (OR 1.57; P=0.029) and high percentage of tumor involvement (OR 1.56; P=0.047). In a Kaplan-Meier curve, a trend was identified that patients with ED had higher incidence of BCR than men with normal EF (P=0.091). Moreover, using a multivariate Cox model, higher preoperative EF was negatively associated with BCR (HR 0.99; P=0.014). Conclusions. These results suggest that the likelihood for adverse pathological outcomes as well as BCR following prostatectomy is higher among men with preoperative ED, though these results require validation in larger datasets. The present study indicates that preoperative ED might be a surrogate for adverse prostate cancer outcomes following.
机译：介绍。勃起功能障碍（ED）与几种合并症有关，包括肥胖，代谢综合症，吸烟和睾丸激素水平低，据报道所有这些都与不良的前列腺癌特征有关。目标。为了检查接受根治性前列腺切除术（RP）的患者术前ED是否与不良前列腺癌特征有关。方法。我们分析了我们机构在2001年至2010年间接受RP的676例患者的数据。采用粗略和调整后的逻辑回归模型研究术前ED与一些病理参数之间的关联。进行了log-rank检验和多元比例风险模型，以确定术前ED与生化复发（BCR）的关系。主要观察指标。使用扩展的前列腺癌指数复合物（EPIC）仪器评估术前勃起功能（EF）。术前正常EF定义为EPIC-SF≥60分，ED定义为术前EPIC-SF低于60分。结果。术前，共有343名（50.7％）男性具有正常EF，而333名（49.3％）男性具有ED。调整协变量后，术前ED被确定为包膜外扩张阳性的危险因素（OR 1.57; P = 0.029）和高肿瘤受累率（OR 1.56; P = 0.047）。在Kaplan-Meier曲线中，发现了一种趋势，即ED患者的BCR发生率高于EF正常的男性（P = 0.091）。此外，使用多元Cox模型，术前EF升高与BCR呈负相关（HR 0.99; P = 0.014）。结论。这些结果表明，术前ED的男性发生前列腺切除术后不良病理结果以及BCR的可能性更高，尽管这些结果需要在更大的数据集中进行验证。本研究表明，术前ED可能是前列腺癌术后不良后果的替代指标。

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