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01-06-2021 | Prostate Cancer | Original Article

Timing and delay of radical prostatectomy do not lead to adverse oncologic outcomes: results from a large European cohort at the times of COVID-19 pandemic

Authors: 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

Published in: World Journal of Urology | Issue 6/2021

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Puliatti S, Eissa A, Eissa R et al (2020) COVID-19 and urology: a comprehensive review of the literature. BJU Int. https://doi.org/10.1111/bju.15071CrossRefPubMed

Stensland KD, Morgan TM, Moinzadeh A et al (2020) Considerations in the triage of urologic surgeries during the COVID-19 pandemic. Eur Urol. https://doi.org/10.1016/j.eururo.2020.03.027CrossRefPubMedPubMedCentral

Ribal MJ, Cornford P, Briganti A, Knoll T, Gravas S, Babjuk M, Harding C, Breda A, Bex A, on behalf of the GORRG Group, Rassweiler JJ, Gözen AS, Pini G, Liatsikos E, Gianluc JN and on behalf of the ESO and the EGP. EAU Guidelines Office Rapid Reaction Group: An organisation-wide collaborative effort to adapt the EAU guidelines recommendations to the COVID-19 era. Eur Urol. https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/HealthAdvance/journals/eururo/EURUROL-D-20–00649–1587127530920.pdf. Published 2020

Abramson Cancer Center at the University of Pennsylvania, City of Hope National Cancer Center, Dana-Farber/Brigham and Women’s Cancer Center, Duke Cancer Institute, Fox Chase Cancer Center, Fred Hutchinson Cancer Research Center/Seattle Cancer Care Allian and V-ICC. Management of prostate cancer during the COVID-19 pandemic. NCCN Guidel. (Coronavirus Disease 2019 (COVID-19) Resources for the Cancer Care Community). https://www.nccn.org/covid-19/pdf/NCCN_PCa_COVID_guidelines.pdf.

van den Bergh RCN, Albertsen PC, Bangma CH et al (2013) Timing of curative treatment for prostate cancer: a systematic review. Eur Urol 64(2):204–215. https://doi.org/10.1016/j.eururo.2013.02.024CrossRefPubMedPubMedCentral

Gupta N, Bivalacqua TJ, Han M et al (2019) Evaluating the impact of length of time from diagnosis to surgery in patients with unfavourable intermediate-risk to very-high-risk clinically localised prostate cancer. BJU Int 124(2):268–274. https://doi.org/10.1111/bju.14659CrossRefPubMed

Loeb S, Folkvaljon Y, Robinson D et al (2016) Immediate versus delayed prostatectomy: Nationwide population-based study*. Scand J Urol 50(4):246–254. https://doi.org/10.3109/21681805.2016.1166153CrossRefPubMedPubMedCentral

Ginsburg KB, Curtis GL, Timar RE, George AK, Cher ML (2020) Delayed radical prostatectomy is not associated with adverse oncological outcomes: implications for men experiencing surgical delay due to the COVID-19 pandemic. J Urol. https://doi.org/10.1097/JU.0000000000001089CrossRefPubMed

Meunier ME, Neuzillet Y, Radulescu C et al (2018) Le delai entre biopsies de prostate et prostatectomie radicale influence-t-il le risque de recidive ? Progrès Urol 28(10):475–481. https://doi.org/10.1016/j.purol.2018.05.003CrossRef

10.

Westerman ME, Sharma V, Bailey GC et al (2019) Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy. Int Braz J Urol 45(3):468–477. https://doi.org/10.1590/s1677-5538.ibju.2018.0196CrossRefPubMedPubMedCentral

11.

Zanaty M, Alnazari M, Ajib K et al (2018) Does surgical delay for radical prostatectomy affect biochemical recurrence? A retrospective analysis from a Canadian cohort. World J Urol 36(1):1–6. https://doi.org/10.1007/s00345-017-2105-6CrossRefPubMed

12.

Fossati N, Rossi MS, Cucchiara V et al (2017) Evaluating the effect of time from prostate cancer diagnosis to radical prostatectomy on cancer control: can surgery be postponed safely? Urol Oncol Semin Orig Investig 35(4):150.e9–150.e15. https://doi.org/10.1016/j.urolonc.2016.11.010CrossRef

13.

Song L, Chen RC, Bensen JT et al (2013) Who makes the decision regarding the treatment of clinically localized prostate cancer-the patient or physician? Cancer 119(2):421–428. https://doi.org/10.1002/cncr.27738CrossRefPubMed

14.

Berry DL, Ellis WJ, Woods NF, Schwien C, Mullen KH, Yang C (2003) Treatment decision-making by men with localized prostate cancer: the influence of personal factors. Urol Oncol Semin Orig Investig 21(2):93–100. https://doi.org/10.1016/S1078-1439(02)00209-0CrossRef

15.

Berry DL, Ellis WJ, Russell KJ et al (2006) Factors That Predict Treatment Choice and Satisfaction with the Decision in Men with Localized Prostate Cancer. Clin Genitourin Cancer 5(3):219–226. https://doi.org/10.3816/CGC.2006.n.040CrossRefPubMed

16.

Geethanath S, Vaughan JT (2019) Accessible magnetic resonance imaging: a review. J Magn Reson Imaging 49(7):e65–e77. https://doi.org/10.1002/jmri.26638CrossRefPubMed

17.

Mottet N, Cornford P, van den Bergh RCN, Briers E, De Santis M, Fanti S, Gillessen S, Grummet J, Henry AM, Lam TB, Mason MD, van der Kwast TH, van der Poel HG, Rouvière O, Schoots IG, Tilki TW. EAU guidelines: prostate cancer 2020. Eur Urol. https://uroweb.org/guideline/prostate-cancer/. Published 2020

18.

Mottet N, Bellmunt J, Bolla M et al (2017) EAU-ESTRO-SIOG guidelines on prostate cancer part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 71(4):618–629. https://doi.org/10.1016/j.eururo.2016.08.003CrossRefPubMed

19.

Tay KJ, Gupta RT, Brown AF, Silverman RK, Polascik TJ (2016) Defining the incremental utility of prostate multiparametric magnetic resonance imaging at standard and specialized read in predicting extracapsular extension of prostate cancer. Eur Urol 70(2):211–213. https://doi.org/10.1016/j.eururo.2015.10.041CrossRefPubMed

20.

Diamand R, Oderda M, Al-Hajj-Obeid W et al (2019) A multicentric study on accurate grading of prostate cancer with systematic and MRI/US fusion targeted biopsies: comparison with final histopathology after radical prostatectomy. World J Urol. 37(10):2109–2117. https://doi.org/10.1007/s00345-019-02634-9CrossRefPubMed

Title: Timing and delay of radical prostatectomy do not lead to adverse oncologic outcomes: results from a large European cohort at the times of COVID-19 pandemic
Authors: 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
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
COVID-19
Prostatectomy
Prostatectomy
Published in: World Journal of Urology / Issue 6/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03402-w

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Timing and delay of radical prostatectomy do not lead to adverse oncologic outcomes: results from a large European cohort at the times of COVID-19 pandemic

Abstract

Purpose

Methods

Results

Conclusion

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