Lessons For COVID-19 Era: Impact of Delays in Surgery on Biochemical Recurrence-Free Survival and Adverse Oncological Outcomes in Patients with Prostate Cancer
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Original Article
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Lessons For COVID-19 Era: Impact of Delays in Surgery on Biochemical Recurrence-Free Survival and Adverse Oncological Outcomes in Patients with Prostate Cancer

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1. Marmara University Faculty of Medicine Department of Urology, İstanbul, Turkey
2. Dokuz Eylül University Faculty of Medicine Department of Urology, İzmir, Turkey
3. Gazi University Faculty of Medicine Department of Urology, Ankara, Turkey
4. Hacettepe University Faculty of Medicine Department of Urology, Ankara, Turkey
5. Çukurova University Faculty of Medicine Department of Urology, Adana, Turkey
6. Ankara University Faculty of Medicine Department of Urology, Ankara, Turkey
7. Acıbadem University Faculty of Medicine Department of Urology, İstanbul, Turkey
8. University of Health Sciences Turkey İzmir Faculty of Medicine, İzmir City Hospital, Department of Urology, İzmir, Turkey
9. Anatoloian Medical Center Clinic of Urology, Kocaeli, Turkey
No information available.
No information available
Received Date: 20.07.2023
Accepted Date: 06.04.2024
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Abstract

Objective: To assess the impact of surgical delay in localized prostate cancer (PCa) on adverse pathological features and oncological outcomes.

Materials and Methods: Patients who underwent surgery for localized PCa were included from the Turkish Urooncology Association PCa database. History of previous treatment or active surveillance was considered an exclusion criterion. Patients were divided into two groups according to the time period between the diagnosis and surgery; less than or equal to 90 days (group 1) or longer than 90 days (group 2). Surgical pathology results and oncological outcomes were compared between the groups.

Results: In total, 2454 out of 3646 patients were assessed. Pathological findings of radical prostatectomy specimens were similar between the two groups. However, there was slightly more seminal vesicle invasion in the final surgical pathology in group 1 (12.9% vs. 9.3%, respectively p=0.042). The 5-year biochemical recurrence-free survival times were similar across all D’Amico risk categories between the two groups. The regression analysis demonstrated seminal vesicle invasion as the only factor affecting the time to prostate-specific antigen progression in high-risk patients (p<0.001 HR=2.51 CI=1.58-4.45).

Conclusion: In conclusion, our results in this large cohort suggest that surgical delay does not cause a deterioration in PCa surgical outcomes, even in high-risk patients. These findings may be helpful for planning limited healthcare resources especially in conditions like the coronavirus disease-2019 pandemic where the availability and optimal use of healthcare system resources are crucial.

Keywords: Bladder cancer, cystectomy, prognosis

References

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