NCCN Categories of Evidence and Consensus
Category 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate.
Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate.
Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate.
Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.
All recommendations are category 2A unless otherwise noted.
Clinical trials: NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged.
Vomvas D, Iconomou G, Soubasi E et al.. Assessment of sexual function in patients with cancer undergoing radiotherapy—a single centre prospective study. Anticancer Res 2012;32:657–664.
Forbat L, White I, Marshall-Lucette S, Kelly D. Discussing the sexual consequences of treatment in radiotherapy and urology consultations with couples affected by prostate cancer. BJU Int 2012;109:98–103.
White ID, Allan H, Faithfull S. Assessment of treatment-induced female sexual morbidity in oncology: is this a part of routine medical follow-up after radical pelvic radiotherapy? Br J Cancer 2011;105:903–910.
Fink HA, Mac Donald R, Rutks IR et al.. Sildenafil for male erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med 2002;162:1349–1360.
Ganz PA, Greendale GA, Petersen L et al.. Managing menopausal symptoms in breast cancer survivors: results of a randomized controlled trial. J Natl Cancer Inst 2000;92:1054–1064.
Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc 2009;84:139–148.
Miles CL, Candy B, Jones L et al.. Interventions for sexual dysfunction following treatments for cancer. Cochrane Database Syst Rev 2007:CD005540.
The Management of Erectile Dysfunction (2005). American Urological Association Web site. Available at: http://www.auanet.org/education/guidelines/erectile-dysfunction.cfm. Accessed February 9, 2014.
Cappelleri JC, Rosen RC. The Sexual Health Inventory for Men (SHIM): a 5-year review of research and clinical experience. Int J Impot Res 2005;17:307–319.
Monga M, Bettencourt R, Barrett-Connor E. Community-based study of erectile dysfunction and sildenafil use: the Rancho Bernardo study. Urology 2002;59:753–757.
Ellis R, Smith A, Wilson S et al.. The prevalence of erectile dysfunction in post-treatment colorectal cancer patients and their interests in seeking treatment: a cross-sectional survey in the west-midlands. J Sex Med 2010;7:1488–1496.
Hendren SK, O’Connor BI, Liu M et al.. Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer. Ann Surg 2005;242:212–223.
Potosky AL, Davis WW, Hoffman RM et al.. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 2004;96:1358–1367.
Resnick MJ, Koyama T, Fan KH et al.. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med 2013;368:436–445.
Schover LR, Fouladi RT, Warneke CL et al.. Defining sexual outcomes after treatment for localized prostate carcinoma. Cancer 2002;95:1773–1785.
Siegel T, Moul JW, Spevak M et al.. The development of erectile dysfunction in men treated for prostate cancer. J Urol 2001;165:430–435.
Stanford JL, Feng Z, Hamilton AS et al.. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000;283:354–360.
Nehra A, Jackson G, Miner M et al.. The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc 2012;87:766–778.
Hubanks JM, Umbreit EC, Karnes RJ, Myers RP. Open radical retropubic prostatectomy using high anterior release of the levator fascia and constant haptic feedback in bilateral neurovascular bundle preservation plus early postoperative phosphodiesterase type 5 inhibition: a contemporary series. Eur Urol 2012;61:878–884.
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. Hubanks JM Umbreit EC Karnes RJ Myers RP Open radical retropubic prostatectomy using high anterior release of the levator fascia and constant haptic feedback in bilateral neurovascular bundle preservation plus early postoperative phosphodiesterase type 5 inhibition: a contemporary series. Eur Urol 2012; 61: 878– 884.
Yang L, Qian S, Liu L et al.. Phosphodiesterase-5 inhibitors could be efficacious in the treatment of erectile dysfunction after radiotherapy for prostate cancer: a systematic review and meta-analysis. Urol Int 2012;90:339–347.
Kloner RA, Hutter AM, Emmick JT et al.. Time course of the interaction between tadalafil and nitrates. J Am Coll Cardiol 2003;42:1855–1860.
Webb DJ, Freestone S, Allen MJ, Muirhead GJ. Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist. Am J Cardiol 1999;83:21C–28C.