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Impact of "time-from-biopsy-to-prostatectomy" on adverse oncological results in patients with intermediate and high-risk prostate cancer

  • Objective: Many patients with localized prostate cancer (PCa) do not immediately undergo radical prostatectomy (RP) after biopsy confirmation. The aim of this study was to investigate the influence of “time-from-biopsy-to- prostatectomy” on adverse pathological outcomes. Materials and Methods: Between January 2014 and December 2019, 437 patients with intermediate- and high risk PCa who underwent RP were retrospectively identified within our prospective institutional database. For the aim of our study, we focused on patients with intermediate- (n = 285) and high-risk (n = 151) PCa using D'Amico risk stratification. Endpoints were adverse pathological outcomes and proportion of nerve-sparing procedures after RP stratified by “time-from-biopsy-to-prostatectomy”: ≤3 months vs. >3 and < 6 months. Medians and interquartile ranges (IQR) were reported for continuously coded variables. The chi-square test examined the statistical significance of the differences in proportions while the Kruskal-Wallis test was used to examine differences in medians. Multivariable (ordered) logistic regressions, analyzing the impact of time between diagnosis and prostatectomy, were separately run for all relevant outcome variables (ISUP specimen, margin status, pathological stage, pathological nodal status, LVI, perineural invasion, nerve-sparing). Results: We observed no difference between patients undergoing RP ≤3 months vs. >3 and <6 months after diagnosis for the following oncological endpoints: pT-stage, ISUP grading, probability of a positive surgical margin, probability of lymph node invasion (LNI), lymphovascular invasion (LVI), and perineural invasion (pn) in patients with intermediate- and high-risk PCa. Likewise, the rates of nerve sparing procedures were 84.3 vs. 87.4% (p = 0.778) and 61.0% vs. 78.8% (p = 0.211), for intermediate- and high-risk PCa patients undergoing surgery after ≤3 months vs. >3 and <6 months, respectively. In multivariable adjusted analyses, a time to surgery >3 months did not significantly worsen any of the outcome variables in patients with intermediate- or high-risk PCa (all p > 0.05). Conclusion: A “time-from-biopsy-to-prostatectomy” of >3 and <6 months is neither associated with adverse pathological outcomes nor poorer chances of nerve sparing RP in intermediate- and high-risk PCa patients.
Metadaten
Author:Tobias A. EnglGND, Philipp MandelORCiDGND, Robert Benedikt HöhORCiDGND, Felix Martin PreißerORCiDGND, Mike WenzelORCiDGND, Clara Julia HumkeGND, Maria-Noemi WelteGND, Jens KöllermannORCiDGND, Peter Johannes WildORCiDGND, Marina Deuker, Luis A. KluthORCiDGND, Frederik RoosGND, Felix ChunORCiDGND, Andreas BeckerGND
URN:urn:nbn:de:hebis:30:3-562174
DOI:https://doi.org/10.3389/fsurg.2020.561853
ISSN:2296-875X
Parent Title (English):Frontiers in Surgery
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Language:English
Date of Publication (online):2020/09/25
Date of first Publication:2020/09/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/10/08
Tag:deferred treatment; delayed treatment; histological outcomes; prognosis; prostate cancer; radical prostatectomy; waiting time
Volume:7
Issue:art. 561853
Page Number:6
First Page:1
Last Page:6
Note:
© 2020 Engl, Mandel, Hoeh, Preisser, Wenzel, Humke, Welte, Köllermann, Wild, Deuker, Kluth, Roos, Chun and Becker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
HeBIS-PPN:472529250
Institutes:Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Licence (German):License LogoCreative Commons - Namensnennung 4.0