The current COVID-19 pandemic is transforming our urologic practice and most urologic societies recommend to defer any surgical treatment for prostate cancer (PCa) patients. It is unclear whether a delay between diagnosis and surgical management (i. e., surgical delay) may have a detrimental effect on oncologic outcomes of PCa patients. The aim of the study was to assess the impact of surgical delay on oncologic outcomes.
Data of 926 men undergoing radical prostatectomy across Europe for intermediate and high-risk PCa according to EAU classification were identified. Multivariable analysis using binary logistic regression and Cox proportional hazard model tested association between surgical delay and upgrading on final pathology, lymph-node invasion (LNI), pathological locally advanced disease (pT3-4 and/or pN1), need for adjuvant therapy, and biochemical recurrence. Kaplan-Meier analysis was used to estimate BCR-free survival after surgery as a function of surgical delay using a 3 month cut-off.
Median follow-up and surgical delay were 26 months (IQR 10-40) and 3 months (IQR 2-5), respectively. We did not find any significant association between surgical delay and oncologic outcomes when adjusted to pre- and post-operative variables. The lack of such association was observed across EAU risk categories.
Delay of several months did not appear to adversely impact oncologic results for intermediate and high-risk PCa, and support an attitude of deferring surgery in line with the current recommendation of urologic societies.
World journal of urology. 2020 Aug 10 [Epub ahead of print]
Romain Diamand, Guillaume Ploussard, Mathieu Roumiguié, Marco Oderda, Daniel Benamran, Gaelle Fiard, Alexandre Peltier, Giuseppe Simone, Julien Van Damme, Bernard Malavaud, Christophe Iselin, Jean-Luc Descotes, Jean-Baptiste Roche, Thierry Quackels, Thierry Roumeguère, Simone Albisinni
Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium. ., Urology Department, La Croix du Sud Hospital, Quint Fonsegrives, France., Urology Department, CHU Toulouse, Toulouse, France., Urology Department, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy., Urology Department, Hôpitaux Universitaires de Genève, Geneva, Switzerland., Urology Department, CHU de Grenoble, Grenoble, France., Urology Department, Jules Bordet Institute, Brussels, Belgium., Urology Department, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy., Urology Department, University Clinics Saint-Luc, Université Catholique de Louvain, Brussels, Belgium., Urology Department, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France., Urology Department, Clinique Saint-Augustin, Bordeaux, France., Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.