The association of phosphodiesterase-5 inhibitors with the biochemical recurrence-free and overall survival of patients with prostate cancer following radical prostatectomy

Kelsey T Danley; Alan Tan; William J Catalona; Robin Leikin; Irene Helenowski; Borko Jovanovic; Michael Gurley; Timothy M Kuzel

doi:10.1016/j.urolonc.2021.05.031

The association of phosphodiesterase-5 inhibitors with the biochemical recurrence-free and overall survival of patients with prostate cancer following radical prostatectomy

Urol Oncol. 2022 Feb;40(2):57.e1-57.e7. doi: 10.1016/j.urolonc.2021.05.031. Epub 2021 Jul 18.

Authors

Kelsey T Danley¹, Alan Tan², William J Catalona³, Robin Leikin⁴, Irene Helenowski⁵, Borko Jovanovic⁵, Michael Gurley⁴, Timothy M Kuzel²

Affiliations

¹ Department of Internal Medicine, Rush University Medical Center, Chicago, IL. Electronic address: kelsey_t_danley@rush.edu.
² Division of Hematology/Oncology/Cell Therapy, Department of Internal Medicine, Rush University Medical Center, Chicago, IL.
³ Department of Urology, Northwestern University, Chicago, IL.
⁴ Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.
⁵ Department of Preventative Medicine, Northwestern University, Chicago, IL.

PMID: 34284930
DOI: 10.1016/j.urolonc.2021.05.031

Abstract

Purpose: To determine whether phosphodiesterase-5 inhibitor documentation is associated with biochemical relapse-free and overall survival of patients with prostate cancer treated with radical prostatectomy.

Materials and methods: We undertook a retrospective cohort analysis of 3,100 patients with prostate cancer treated with radical prostatectomy between 2003 and 2015. The patients were categorized as a phosphodiesterase- 5- inhibitor user or non-user. The biochemical relapse-free and overall survival at 5-years and 10-years were determined.

Results: Of the patients, 1,372 reported phosphodiesterase-5 inhibitor documentation, and 1,728 did not. The biochemical recurrence-free survival for non-users at 5- and 10-years follow-up was 87.6% and 85.3%, respectively, and the overall survival at these time intervals was 97.9% and 94.5%. The biochemical recurrence-free survival for phosphodiesterase-5 inhibitor users was 94.3% and 93.2% at 5- and 10-years follow-up, respectively, and overall survival was 99.2% and 95.8% at these intervals. The hazard ratio for biochemical recurrence-free survival was 0.44 (CI 0.34-0.56) and for overall survival was 0.65 (CI 0.45-0.94). On the multivariate analysis, phosphodiesterase-5 inhibitor documentation was associated with a lower risk of biochemical recurrence and death when corrected for the other variables. Age at surgery and Gleason scores >8 was associated with a higher risk of death. Higher pathological stage, higher Gleason score, presence of lymph node metastases, and nonwhite race were associated with a higher risk of recurrence.

Conclusion: This retrospective analysis revealed a significant association of postoperative phosphodiesterase-5 inhibitor documentation with biochemical recurrence-free- and overall survival in patients with localized prostate cancer treated with radical prostatectomy. Larger scale studies are warranted to investigate the clinical significance of this association.

Keywords: Genitourinary Cancer; Medical Therapy; Prostatic Neoplasms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Humans
Male
Middle Aged
Phosphodiesterase 5 Inhibitors / pharmacology
Phosphodiesterase 5 Inhibitors / therapeutic use*
Prostatectomy / methods*
Prostatic Neoplasms / mortality
Prostatic Neoplasms / surgery*
Retrospective Studies
Survival Analysis

Substances

Phosphodiesterase 5 Inhibitors