Impact of the length of time between diagnosis and surgical removal of urologic neoplasms on survival - Abstract

OBJECTIVE: Our aim was to assess the effect of surgical wait time on the survival of patients with urological neoplasms, including prostate, bladder, penile, and testicular cancers and upper tract tumours (UTUC).

MATERIALS AND METHODS: Current, relevant studies were identified from the literature. Keywords used for article retrieval were as follows: delay; surgery; prostate cancer; urothelial carcinoma; renal cell carcinoma; testicular cancer; bladder; renal pelvis; ureter; and survival.

RESULTS: Regarding the length of surgical wait time, it does not matter in cases of incidental T1a renal cell carcinomas. In other cases of renal cell carcinomas, surgery should be considered within < 1 month; it is of crucial importance in bladder cancer and should be < 1 month for a TURBT in cases of non-muscle-invasive bladder cancer and < 1 month for a radical cystectomy in cases of muscle-invasive bladder cancer; it is important in invasive UTUC and should be < 1 month for a radical nephroureterectomy; it is not crucial in cases of low-risk prostate cancer. In any other case, radical prostatectomy should be considered within < 2 months; it is important in testicular cancer and should be fewer than 10 days for an orchiectomy.

CONCLUSION: Prolonged surgical wait times have an impact on the overall quality of life and anxiety of the patient. Extending the wait time beyond a given threshold can also have a negative impact on the patient's clinical outcomes, but this threshold differs between urological neoplasms.

Written by:
Bourgade V, Drouin SJ, Yates DR, Parra J, Bitker MO, Cussenot O, Rouprêt M.   Are you the author?
Academic Department of Urology of La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, University Paris VI, 47-83 bvd de l'Hôpital, 75013, Paris, France.

Reference: World J Urol. 2013 Mar 2. Epub ahead of print.
doi: 10.1007/s00345-013-1045-z

PubMed Abstract
PMID: 23455886 Testicular Cancer Section