EAU 2018: Does the Delay from Prostate Biopsy to Radical Prostatectomy Influence the Risk of Biochemical Recurrence?
A single center retrospective analysis of patients diagnosed between January 2013 and January 2017, and treated with RP for localized PC was performed. All relevant clinical, biological and histological data were collected on 513 included patients. The primary endpoint was the assessment of the risk of BCR by the difference between post-biopsy USCF-CAPRA and post-surgical CAPRA-S scores. The secondary endpoint was the evaluation of the upgrading by the difference between the Gleason score on biopsy and on surgical specimen.
The median age at the time of the biopsy was 65 years (IQR: 60 - 69). The median preoperative PSA was 7.30 ng / mL (IQR: 5.60 - 9.94), and the median time between biopsy and surgery was 108 days (IQR: 86-141). For the entire cohort, the risk of BCR was significantly higher above a threshold of 90 days (p = 0.039). No threshold was found for Gleason 6 (3 + 3) patients. A 90-day threshold was found for Gleason 7 (3 + 4) patients (p = 0.038). Gleason patients ≥ 8 had more upgrading beyond a 60-day threshold (p = 0.040).
This study demonstrated that after a 3 months delay, the risk of BCR is significantly higher for localized PC. It seems possible to extend this period for low-risk patients, whereas it seems necessary not to extend it for intermediate-risk patients, and to reduce it to 2 months for high-risk patients.
Presented by: Meunier M.E, Hopital Foch, Dept. of Urology, Suresnes, France
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, twitter: @GoldbergHanan at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark