Delays in Radical Prostatectomy: Oncologic Outcomes in High-Risk Prostate Cancer
Posted: Friday, February 19, 2021
The COVID-19 pandemic has negatively affected the rate at which patients receive medical care. Colton H. Walker, MD, of Michigan Medicine, and colleagues conducted a study to explore the impact of treatment delay on oncologic outcomes in patients with prostate cancer. Their research suggested that a treatment delay of less than 6 months from diagnosis did not seem to show an increase in adverse pathology or biochemical recurrence. Their findings were presented at the 2020 Annual Meeting of the Society of Urologic Oncology (SUO; Abstract 191).
A total of 8,355 patients with intermediate-risk and 2,774 patients with high-risk prostate cancer underwent radical prostatectomy within 12 months of diagnosis; they were identified from the Michigan Urological Surgery Improvement Collaborative registry. Participants were classified into the immediate group if they received treatment within 3 months of diagnosis. The delayed group included individuals who waited either 3.1 to 6 months, 6.1 to 9 months, or 9.1 to 12 months between diagnosis and radical prostatectomy.
Of the patients with intermediate-risk disease, 60.0%, 33.6%, 4.6%, and 1.8% underwent radical prostatectomy less than 3 months, 3.1 to 6 months, 6.1 to 9 months, and 9.1 to 12 months following diagnosis, respectively. In comparison, the respective rates were 71.3%, 26.0%, 2.1%, and 0.7% for patients with high-risk disease who underwent surgery after diagnosis.
Delays in surgery of up to 6 months showed no significant risk of adverse pathology in patients with intermediate-risk disease, yet it was observed with delays of between 6 and 9 months. Additionally, delays of up to 9 months had no apparent effect on time to biochemical recurrence in these patients, whereas it did when delayed between 9 and 12 months. In patients with high-risk disease, delaying surgery up to 12 months and 6 months showed no significant difference in the risk of adverse pathology or in the time to biochemical recurrence, respectively.
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