Association between Delay to Radical Prostatectomy and Clinically Meaningful Outcomes among Patients with Intermediate and High-Risk Localized Prostate Cancer.

Abstract

PURPOSE:

There are limited data regarding the effect of treatment delays on important long-term outcomes among men with intermediate/high-risk prostate cancer (PC).

MATERIALS AND METHODS:

We identified 3,962 men with intermediate/high-risk disease from the SEARCH cohort treated with radical prostatectomy (RP) from 1988 to 2018. Cox proportional hazard models assessed the association between time from biopsy to RP (up to 1 year) and time to castration-resistant PC (CRPC), metastasis and all-cause mortality. Interaction terms were used to test for effect modification by risk group.

RESULTS:

Of the 3,962 men, 167 developed CRPC, 248 developed metastases and 884 died after a median followup of 85 months. Longer delays between biopsy and RP were associated with a decreased risk of CRPC (adjusted HR=0.88, 95% CI: 0.80-0.98, p=0.02), independent of D'Amico risk group (interaction p >0.05). In men with intermediate and high-risk disease, we found no statistically significant association between length of time to RP and risk of developing metastases (p=0.5 and 0.9, respectively) or all-cause mortality (p=0.1 and 0.1, respectively).

CONCLUSIONS:

Among men with intermediate and high-risk PC, we found no statistically significant increased risk of adverse long-term outcomes, including CRPC, metastasis and death, for men who had treatment delays up to 1 year following PC diagnosis.

• Authors: Maggie C Lee, Tyler R Erickson, Shannon Stock, Lauren E Howard, Amanda M De Hoedt, Christopher L Amling, William J Aronson, Matthew R Cooperberg, Christopher J Kane, Martha K Terris, Zachary Klaassen, Stephen J Freedland, Christopher J D Wallis
• Journal: The Journal of urology (J Urol) Vol. 207 Issue 3 Pg. 592-600 (03 2022) ISSN: 1527-3792 [Electronic] United States
• PMID: 34694910 (Publication Type: Journal Article, Multicenter Study)

Topics

• Aged
• Biopsy
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prostate (pathology, surgery)
• Prostatectomy (methods)
• Prostatic Neoplasms (pathology, surgery)
• Retrospective Studies
• Risk Factors
• Time Factors