Urinary Incontinence-85: An Expanded Prostate Cancer Composite (EPIC) Score Cutoff Value for Urinary Incontinence Determined Using Long-term Functional Data by Repeated Prospective EPIC-Score Self-assessment After Radical Prostatectomy
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Purpose: To determine an objective cutoff value (COV) for urinary incontinence (UI) using the Expanded Prostate Cancer Composite (EPIC) score after radical prostatectomy (RP). Methods: From 2004–2013, all RP patients at our institution completed the EPIC urinary domain (EPIC-UD) questionnaire preoperatively and 6 weeks; 3, 6, 9, 12, and 18 months postoperatively; and yearly thereafter. The EPIC-UD is composed of several questions, 4 of which address UI qualitatively (EPIC-UI). Furthermore, patients were asked to complete a global quality of life (QoL) questionnaire regarding continence. The EPIC COV was calculated using receiver operating characteristic (ROC) analysis. Correlations between the EPIC-UI and quantitative QoL were evaluated using the Kendall-Tau test. Results: We analyzed 239 patients with a median age of 63 years (interquartile range [IQR], 59–66 years), a median follow-up of 48 months (IQR, 30–78 months) and a median preoperative EPIC-UI score of 100 (IQR, 91.75–100). The ROC analysis for the distinction between EPIC-UI and the use of ≤1 pad/day yielded an EPIC-UI COV of >85, which we termed the UI-85, with an area under the curve of 0.857 (P<0.0001). A stronger correlation was seen between QoL scores and the UI-85 (1 year postoperatively: correlation coefficient [CC], 0.592; P<0.0001) than between QoL and not using a pad (CC, 0.512; P<0.0001). Conclusions: The calculated COV of the EPIC-UI for continence was 85. UI is a multidimensional condition that cannot be adequately characterized by a single piece of information, such as pad usage only. Hence, the UI-85 represents a nuanced and straightforward tool for monitoring and comparing continence between different time points and cohorts in a multidimensional and objective manner.
Abstract
Purpose: To determine an objective cutoff value (COV) for urinary incontinence (UI) using the Expanded Prostate Cancer Composite (EPIC) score after radical prostatectomy (RP). Methods: From 2004–2013, all RP patients at our institution completed the EPIC urinary domain (EPIC-UD) questionnaire preoperatively and 6 weeks; 3, 6, 9, 12, and 18 months postoperatively; and yearly thereafter. The EPIC-UD is composed of several questions, 4 of which address UI qualitatively (EPIC-UI). Furthermore, patients were asked to complete a global quality of life (QoL) questionnaire regarding continence. The EPIC COV was calculated using receiver operating characteristic (ROC) analysis. Correlations between the EPIC-UI and quantitative QoL were evaluated using the Kendall-Tau test. Results: We analyzed 239 patients with a median age of 63 years (interquartile range [IQR], 59–66 years), a median follow-up of 48 months (IQR, 30–78 months) and a median preoperative EPIC-UI score of 100 (IQR, 91.75–100). The ROC analysis for the distinction between EPIC-UI and the use of ≤1 pad/day yielded an EPIC-UI COV of >85, which we termed the UI-85, with an area under the curve of 0.857 (P<0.0001). A stronger correlation was seen between QoL scores and the UI-85 (1 year postoperatively: correlation coefficient [CC], 0.592; P<0.0001) than between QoL and not using a pad (CC, 0.512; P<0.0001). Conclusions: The calculated COV of the EPIC-UI for continence was 85. UI is a multidimensional condition that cannot be adequately characterized by a single piece of information, such as pad usage only. Hence, the UI-85 represents a nuanced and straightforward tool for monitoring and comparing continence between different time points and cohorts in a multidimensional and objective manner.
참고문헌 (17)
- Abrams P, "ICIQ Advisory Board. The International Consultation on Incontinence Modular Questionnaire:www.iciq.net", J Urol, 175(3 Pt 1), pp.1063~1066 (2006)
- Litwin MS, "The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure", Med Care, 36, pp.1002~1012 (1998)
- Wei JT, "Development and validation of the expanded prostate cancer index composite(EPIC)for comprehensive assessment of health-related quality of life in men with prostate cancer", Urology, 56, pp.899~905 (2000)
- Sandhu JS, "Urinary dysfunction in prostate cancer: a mangement guide" (2016), Springer International Publishing
- Tsui JF, "Pad count is a poor measure of the severity of urinary incontinence", J Urol, 190, pp.1787~1790 (2013)
- Nitti VW, "Correlation of patient perception of pad use with objective degree of incontinence measured by pad test in men with postprostatectomy incontinence : the SUFU Pad Test Study", J Urol, 192, pp.836~842 (2014)
- Yaxley JW, "Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy : early outcomes from a randomised controlled phase 3 study", Lancet, 388, pp.1057~1066 (2016)
- Annika Herlemann, "Community-based Outcomes of Open versus Robot-assisted Radical Prostatectomy", European Urology (2017), Elsevier BV[DOI]
- Ong WL, "Comparison of oncological and health-related quality of life outcomes between open and robot-assisted radical prostatectomy for localised prostate cancer-findings from the population-based Victorian Prostate Cancer Registry", BJU Int, 118, pp.563~569 (2016)
- Wallerstedt A, "Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open radical prostatectomy", Eur Urol, 67, pp.660~670 (2015)
- Burkhard FC, "Nerve sparing open radical retropubic prostatectomy--does it have an impact on urinary continence?", J Urol, 176, pp.189~195 (2006)
- Nandipati KC, "Nerve-sparing surgery significantly affects long-term continence after radical prostatectomy", Urology, 70, pp.1127~1130 (2007)
- Reeves F, "Preservation of the neurovascular bundles is associated with improved time to continence after radical prostatectomy but not long-term continence rates : results of a systematic review and meta-analysis", Eur Urol, 68, pp.692~704 (2015)
- 박용현, "Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction", International Neurourology Journal, 20(1), pp.69~74 (2016), 대한배뇨장애요실금학회
- Kundu SD, "Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies", J Urol, 172(6 Pt 1), pp.2227~2231 (2004)
- Tzou DT, "The failure of a nerve sparing template to improve urinary continence after radical prostatectomy : attention to study design", Urol Oncol, 27, pp.358~362 (2009)
- Lehmann K, "Are functional cavernous nerves relevant for urinary continence after radical prostatectomy?", J Urol, 181(4 Suppl), pp.719~ (2009)