A Detailed Analysis of the Association Between Postoperative Phosphodiesterase Type 5 Inhibitor Use and the Risk of Biochemical Recurrence After Radical Prostatectomy.

Abstract

UNLABELLED:

A recent study reported a detrimental effect of phosphodiesterase type 5 inhibitors (PDE5-Is) on biochemical recurrence (BCR) after radical prostatectomy (RP) for prostate cancer (PCa). We tested the association between PDE5-I use, PDE5-I therapy scheme, number of PDE5-I pills taken, and BCR in 2579 patients treated with bilateral nerve-sparing RP for PCa between 2004 and 2013 at a single center. Patients were categorized according to PDE5-I use within 2 yr after surgery as on demand, rehabilitation schedule (daily PDE5-I use for at least 3 mo), and no PDE5-I use. Multivariable (MVA) Cox regression models tested the association between PDE5-I and BCR. The same analyses were repeated using the number of PDE5-I pills taken by each patient. Overall, 674 patients (26.1%) received PDE5-Is. At MVA analysis, PDE5-I use, type of administration schedule, and number of PDE5-I pills were not significantly associated with higher risk of BCR (all p ≥ 0.2) after accounting for multiple confounders including time from RP to PDE5-I use. While awaiting further studies, patients should not be denied PDE5-I treatment after RP.

PATIENT SUMMARY:

Among patients treated with radical prostatectomy, phosphodiesterase type 5 inhibitor use was not associated with an increased risk of biochemical recurrence, regardless of the therapeutic regimen used.

• Authors: Andrea Gallina, Marco Bianchi, Giorgio Gandaglia, Vito Cucchiara, Nazareno Suardi, Francesco Montorsi, Alberto Briganti
• Journal: European urology (Eur Urol) Vol. 68 Issue 5 Pg. 750-3 (Nov 2015) ISSN: 1873-7560 [Electronic] Switzerland
• PMID: 25700565 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Chemical References

• Phosphodiesterase 5 Inhibitors
• KLK3 protein, human
• Kallikreins
• Prostate-Specific Antigen

Topics

• Aged
• Erectile Dysfunction (drug therapy)
• Humans
• Kallikreins (blood)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasm Recurrence, Local (blood, epidemiology)
• Phosphodiesterase 5 Inhibitors (therapeutic use)
• Postoperative Complications (drug therapy)
• Proportional Hazards Models
• Prostate-Specific Antigen (blood)
• Prostatectomy
• Prostatic Neoplasms (blood, surgery)
• Risk Factors