Prevalence of Adverse Effects Among Prostate Cancer Patients Following Robotic-Assisted Laparoscopic Prostatectomy, External Beam Radiation Therapy, or Combined Therapy in North Florida

Introduction: Robotic-assisted laparoscopic prostatectomy (RALP) and external beam radiation therapy (EBRT) are two widely recognized clinical standards for treating localized prostate cancer (PCa). This study aims to investigate the prevalence of various post-treatment side effects after RALP, EBRT, and the combination of RALP followed by EBRT. Methods: This retrospective study utilized a large-scale bioinformatics database through the UF Health Integrated Data Repository, Informatics for Integrating Biology and the Bedside (i2b2 1.7.12a PROD). Males over the age of 35 with PCa who underwent RALP, EBRT, or RALP followed by EBRT were identified. Participants who received other treatments for PCa were excluded. International Classification of Diseases (ICD)-9, ICD-10, and Current Procedural Terminology (CPT) codes were used to identify patients with PCa and post-treatment side effects, while CPT codes were used to isolate those who underwent RALP, EBRT, or RALP followed by EBRT. Patients diagnosed with a given complication before receiving treatment were excluded from the analysis. SPSS was used for all statistical analyses, which consisted of multiple independent chi-square tests. Percentages for each postoperative complication were calculated using the total number of participants who received each treatment. Results: A total of 2329576 patients were identified from June 2011 to December 2024. Of these, 752491 were males over 35 years old. Among 17729 patients with PCa, 1148 (6.48%) received RALP, 1399 (7.89%) underwent EBRT, and 144 (0.81%) underwent RALP followed by EBRT. The most common side effects in men who underwent RALP were stress incontinence, 690 (60.10%); erectile dysfunction, 567 (49.39%); and gross hematuria, 63 (5.49%). The most common side effects in men who underwent EBRT were erectile dysfunction, 157 (11.22%); gross hematuria, 118 (8.43%); and pelvic pain, 67 (4.79%). The most common side effects in men who underwent RALP followed by EBRT were erectile dysfunction, 142 (98.61%); stress incontinence, 22 (15.28%); and gross hematuria, 21 (14.58%). Gross hematuria, bladder cancer, and prostate-specific antigen (PSA) elevation were significantly more likely in patients who underwent EBRT. Stress incontinence and erectile dysfunction were significantly more common in patients who underwent RALP. Conclusion: Each treatment modality differs in its postoperative complication profile. Further investigation of these findings is needed to better assess treatment risks and guide physician decision-making for optimal patient outcomes.