Table 2 –
Propensity-weighted PCSI sexual, urinary and bowel domain scores over time across different treatment groups
| Active Surveillance | External Beam RT | Brachytherapy | Radical Prostatectomy | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Sexual Dysfunction | N** | Mean (95%CI) | N** | Mean (95%CI) | Mean Diff Score vs. AS (95%CI) | N** | Mean (95%CI) | Mean Diff Score vs. AS (95% CI) | N** | Mean (95%CI) | Mean Diff Score vs. AS (95% CI) |
| Baseline | 310 | 43.4 (39.2-47.6) | 248 | 41.8 (36.3-47.2) | −1.6 (−8.5,5.2) | 106 | 46.4 (36.1-56.7) | 3.0 (−8.1,14.1) | 465 | 41.6 (35.6-47.6) | −1.8 (−9.1,5.5) |
| 3 months | 299 | 44.6 (40.2-48.9) | 229 | 58.5 (52.7-64.2) | 13.9 (6.7,21.2) | 107 | 61.7 (53.4-70.1) | 17.1 (7.8,26.6) | 440 | 80.8 (77.0-84.6) | 36.2 (30.4,42.0)* |
| 12 months | 272 | 48.1 (43.8-52.4) | 215 | 58.2 (52.7-63.7) | 10.2 (3.1,17.1) | 96 | 62.4 (53.9-70.9) | 14.3 (4.6,24.0) | 414 | 75.7 (71.8-79.6) | 27.6 (21.8,33.4)* |
| 24 months | 229 | 56.6 (52.1-61.0) | 187 | 59.2 (53.6-64.7) | 2.6 (−4.8,10.0) | 78 | 61.6 (53.5-69.7) | 5.0 (−4.2,14.2) | 375 | 73.7 (69.2-78.1) | 17.1 (10.9,23.3) |
| Urinary Obs and Irr | |||||||||||
| Baseline | 307 | 22.8 (21.2-24.3) | 248 | 22.3 (20.3-24.4) | −0.5 (−3.0,2.2) | 107 | 20.8 (18.3-23.3) | −2.0 (−4.9,1.0) | 465 | 22.6 (21.1-24.2) | −0.2 (−2.3,2.1) |
| 3 months | 298 | 23.2 (21.7-24.6) | 234 | 34.9 (32.2-37.6) | 11.7 (8.7,14.8)* | 104 | 43.7 (38.4-48.9) | 20.5 (15.1,25.9)* | 431 | 27.3 (25.4-29.1) | 4.1 (1.7,6.5) |
| 12 months | 278 | 26.2 (24.4-27.9) | 217 | 23.9 (21.7-26.1) | −2.3 (−5.1,0.6) | 93 | 31.7 (27.0-36.4) | 5.5 (0.4,10.6) | 417 | 21.9 (20.0-23.7) | −4.3 (−6.9,−1.7) |
| 24 months | 222 | 25.3 (23.5-27.1) | 188 | 23.0 (20.7-25.2) | −2.3 (−5.2,0.6) | 80 | 28.2 (24.4-32.0) | 2.9 (−1.3,7.0) | 376 | 19.6 (17.8-21.4) | −5.7 (−8.2,−3.1) |
| Urinary Incontinence | |||||||||||
| Baseline | 308 | 10.4 (8.2-12.8) | 241 | 9.9 (7.5-12.4) | −0.6 (−3.9,2.8) | 108 | 10.5 (3.8-17.2) | 0 (−7.1,7.1) | 462 | 9.7 (7.2-12.2) | −0.8 (−4.2,2.6) |
| 3 months | 301 | 12.0 (9.7-14.4) | 227 | 15.6 (12.3-19.0) | 3.6 (−0.5,7.7) | 107 | 18.1 (12.5-23.7) | 6.1 (0,12.2) | 406 | 45.6 (40.3-50.8) | 33.6 (27.8,39.2)* |
| 12 months | 276 | 14.1 (11.4-16.7) | 216 | 15.3 (11.9-18.6) | 1.2 (−3.1,5.5) | 95 | 13.9 (8.6-19.3) | −0.2 (−6.2,5.9) | 413 | 32.3 (27.7-36.9) | 18.2 (12.9,23.5)* |
| 24 months | 226 | 17.6 (14.6-20.6) | 190 | 16.6 (13.3-20.0) | −1.0 (−5.5,3.6) | 79 | 15.3 (9.9-20.8) | −2.3 (−8.5,3.9) | 374 | 33.0 (27.2-38.8) | 15.4 (8.9,21.9)* |
| Bowel Problems | |||||||||||
| Baseline | 314 | 5.9 (5.0-6.8) | 246 | 5.7 (4.6-6.7) | −0.2 (−1.6,1.1) | 109 | 6.1 (4.5-7.6) | 0.2 (−1.6,2.0) | 467 | 6.2 (5.2-7.3) | 0.3 (−1.1,1.7) |
| 3 months | 302 | 7.1 (6.0-8.2) | 235 | 12.0 (9.8-14.3) | 4.9 (2.4,7.4)* | 108 | 9.0 (6.9-11.1) | 1.9 (−0.5,4.3) | 444 | 6.7 (5.5-7.8) | −0.4 (−2.0,1.2) |
| 12 months | 279 | 7.2 (6.0-8.4) | 218 | 9.0 (7.3-10.7) | 1.8 (−0.3,3.9) | 96 | 7.0 (5.2-8.8) | −0.2 (−2.4,2.0) | 420 | 5.8 (4.9-6.8) | −1.4 (−2.9,0.2) |
| 24 months | 229 | 6.2 (5.3-7.1) | 190 | 9.9 (7.4-12.4) | 3.7 (1.0,6.4) | 81 | 6.8 (4.9-8.6) | 0.6 (−1.5,2.7) | 379 | 5.2 (4.4-6.0) | −1.0 (−2.2,0.3) |
Abbreviations: PCSI, Prostate Cancer Symptom Indices; RT, radiotherapy; obs and irr, obstruction and irritation; diff, difference.
Missing data were imputed.
PCSI domains:6 scores range from 0 to 100, with higher score indicating more symptoms and dysfunction. Minimally clinically important difference is not defined for this instrument.
denotes clinically meaningful difference (vs. active surveillance) based on exceeding the threshold of ½ standard deviation of the active surveillance baseline score. As reported in Table 1, standard deviation scores were: urinary obstruction/irritation (13.5), urinary incontinence (20.4), bowel problems (8.0), and sexual dysfunction (37.6)
raw (unweighted) numbers of patients with non-missing data.
Among active surveillance patients, 18.7% received treatment within 24 months: 6.2% radical prostatectomy, 6.9% external beam RT, 3.1% brachytherapy, and 2.4% other.