|
KMID : 1037120230410040892
|
|
The World Journal of Men′s Health
2023 Volume.41 No. 4 p.892 ~ p.899
|
|
|
Phosphodiesterase-5 Inhibitor Use in Robot Assisted Radical Prostatectomy Patients Is Associated with Reduced Risk of Death: A Propensity Score Matched Analysis of 1,058 Patients
|
|
Lee Jong-Soo
Kim Hye-Rim
Jang Won-Sik
Lee Kwang-Suk
Kang Sung-Ku
Han Hyun-Ho
Choi Young-Deuk
|
|
|
Abstract
|
|
|
Purpose: We investigated whether the use of a phosphodiesterase-5 inhibitor (PDE5i) after robot assited radical prostatectomy has a survival benefit over non-use patients because there are controversial results on the association between PDE5i use and survival outcomes for prostate cancer patients in literature.
Materials and Methods: We designed a retrospective, matched, large-sample cohort study of 5,545 patients who underwent robot assisted radical prostatectomy (RARP) during 2013?2021 in a single institute. The exclusion criteria was patients who were aged >70 years at surgery, American Society of Anesthesiologists (ASA) physical status classification grade 4 or 5, history of other malignancies, patients who started PDE5i 6 months after survery and patients with follow up period less than 24 months after surgery. Among the 1,843 included patients, 1,298 were PDE5i users, and 545 were PDE5i non-users. We performed propensity score matching (PSM) of PDE5i users (n=529) with non-users (n=529) by adjusting for the variables of age, Gleason grade group, pathological T stage, preoperative ASA physical status grade, and International Index of Erectile Function score.
Results: There were no significant difference in patient characteristics according to PSM. Kaplan?Meier curve revealed the difference of overall survival for PDE5i users and non-users (clustered log-rank test p<0.05). In a stratified Cox regression analysis, PDE5i use after RARP was associated with improved overall survival and reduced risk of death (hazard ratio 0.43; confidence interval 0.24?0.79; p=0.007). The limitation of this study was that the indication for the prescription of PDE5i was not given.
Conclusions: PDE5i administration after RARP were associated with overall survival of patients with prostate cancer. A further randomized control trial may reveal whether routine use of PDE5i after prostatectomy can improve survival of prostate cancer patient.
|
|
|
KEYWORD
|
|
|
Erectile dysfunction, Phosphodiesterase 5 inhibitors, Prostatectomy, Prostatic neoplasms, Surviva
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|