Is time from diagnosis to radical prostatectomy associated with oncological outcomes?

World J Urol. 2019 Aug;37(8):1571-1580. doi: 10.1007/s00345-018-2570-6. Epub 2018 Nov 27.

Abstract

Purpose: To study the association between time from diagnosis to radical prostatectomy (RP-interval) and prostate cancer-specific mortality (PCSM), histological findings in the RP-specimen and failure after RP (RP-failure).

Methods: Patients diagnosed with non-metastatic prostate cancer (PCa) in 2001-2010 and prostatectomized within 180 days of biopsy were identified in the Cancer Registry of Norway and the Norwegian Prostate Cancer Registry. Patients were stratified according to risk groups and RP-intervals of 0-60, 61-90, 91-120 and 121-180 days. Aalen-Johansen and Kaplan-Meier methods estimated curves for PCSM, RP-failure and overall mortality. Multivariable Cox regressions and Chi-square tests were used to evaluate the impact of RP-interval on outcomes.

Results: In 5163 eligible patients, the median time from diagnosis to RP was 93 days (range 1-180). Risk group distribution was similar in all RP-interval groups. With almost eight years of observation, no association was found between RP-interval and PCSM in the intermediate-or high-risk groups. Increasing RP-interval did not increase the rate of adverse histological outcomes or incidence of RP-failure.

Conclusions: Increasing RP-interval up to 180 days was not associated with adverse oncological outcomes at eight years follow-up. These findings should be considered when planning for prostatectomy.

Keywords: Mortality; Outcomes; Prostate cancer; Radical prostatectomy; Timing.

MeSH terms

  • Aged
  • Cohort Studies
  • Humans
  • Male
  • Middle Aged
  • Prostatectomy* / methods
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / surgery*
  • Time-to-Treatment / statistics & numerical data*
  • Treatment Outcome