Combined reporting of cancer control and functional results of radical prostatectomy

Eur Urol. 2003 Dec;44(6):656-60. doi: 10.1016/j.eururo.2003.09.009.


Introduction: The results of radical prostatectomy (cancer control, continence and sexual potency) are currently presented separately, while the success of this surgery depends on a combination of good cancer control with maintenance of continence and erections. We propose a score to jointly evaluate and report cancer control and functional results.

Methods: The results of 205 radical prostatectomies were studied at one year. Cancer control was evaluated by PSA. Continence and sexual potency were evaluated by a self-administered questionnaire. Each patient was attributed 0 or 4 points according to the presence of absence of biochemical progression (PSA>0.2 ng/ml), 0 or 2 points according to the presence or absence of urinary incontinence (use of pads) and 0 or 1 point according to the presence or absence of impotence (no erections). The sum of these points provided a score classifying the patient into 8 distinct categories, from 0 to 7, each corresponding to a specific status (from 0 (0+0+0): no cancer control-incontinence-impotence to 7 (4+2+1): cancer control-continence-sexual potency).

Results: One year after the operation, 175 (85%) of patients had a PSA less than 0.2 ng/ml, 135 (65.8%) were continent and 64 (32.7%) reported erections. All patients with a score > or =4 had good cancer control, with no functional disorders for a score of 7 (4+2+1) (20%), no disorders of continence for a score of 6 (4+2+0) (31.5%), no disorders of erection for a score of 5 (4+0+1) (8.3%), or with incontinence and impotence for a score of 4 (4+0+0) (21.9%). All patients with a score <4 had a PSA>0.2 ng/ml, but with no functional disorders for a score of 3 (0+2+1) (2.4%), no incontinence for a score of 2 (0+2+0) (8.3%), and no impotence for a score of 1 (0+0+1) (1.9%). 1.9% of patients were incontinent, impotent and showed signs of biochemical progression (score 0=0+0+0).

Conclusion: This score allows analysis of the global (cancer control and functional) results of radical prostatectomy and would facilitate comparisons between various surgical techniques (type of approach, nerve-sparing techniques) and various centres.

MeSH terms

  • Aged
  • Biopsy, Needle
  • Cohort Studies
  • Erectile Dysfunction / epidemiology*
  • Erectile Dysfunction / etiology
  • Follow-Up Studies
  • Germany
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Patient Satisfaction
  • Postoperative Complications / epidemiology
  • Probability
  • Prostate-Specific Antigen / blood*
  • Prostatectomy / adverse effects*
  • Prostatectomy / methods*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Quality of Life
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome
  • Urinary Incontinence / epidemiology*
  • Urinary Incontinence / etiology


  • Prostate-Specific Antigen