PURPOSE: In many centers patients with clinically localized prostate cancer might be confronted with a delay in therapy due to not immediately available treatment capacity at that specific center. Furthermore, a growing amount of patients want to have a second or third opinion before they finally decide what therapeutic option to choose. We investigated whether a reasonable delay from diagnosis to definitive treatment impact recurrence free survival rates in men undergoing radical prostatectomy (RP) for localized prostate cancer. MATERIAL AND METHODS: Preoperative data of 795 men treated for localized prostate cancer by RP between 1/1992 and 6/2000 were evaluated including pretreatment PSA, clinical stage and biopsy Gleason score. In addition, time from biopsy to the date of RP was obtained and investigated as a potential prognostic factor. The influence of the time gap between biopsy and surgery was statistically evaluated by univariate Cox regression analyses and Kaplan-Meier analyses; a multivariate Cox Modell was performed including all preoperative parameters. Relapse following RP was defined as a postoperative PSA level >0.1 ng/ml. RESULTS: Mean followup of the patients was 33 months (1-116 months). Twenty-five percent of the patients failed during that time period. Mean time gap between diagnosis and treatment was 62 days (median 54 days) ranging from 5 to 518 days. Univariate Cox regression analysis showed no significant correlation (p=0.062) of waiting time with recurrence rate. Multivariate Cox regression documented a highly significant association of PSA (p<0.001), clinical stage (p=0.001) and biopsy Gleason grade (p<0.001) but not not for time to treatment (p=0.841). In patients with high-grade cancer again no significant impact of treatment delay was found. CONCLUSION: Treatment delay in the investigated time span of a few months did not adversely affect recurrence free survival rates. Patients can be reassured that they can evaluate treatment options without compromising efficacy due to a delay in treatment.
PURPOSE: In many centers patients with clinically localized prostate cancer might be confronted with a delay in therapy due to not immediately available treatment capacity at that specific center. Furthermore, a growing amount of patients want to have a second or third opinion before they finally decide what therapeutic option to choose. We investigated whether a reasonable delay from diagnosis to definitive treatment impact recurrence free survival rates in men undergoing radical prostatectomy (RP) for localized prostate cancer. MATERIAL AND METHODS: Preoperative data of 795 men treated for localized prostate cancer by RP between 1/1992 and 6/2000 were evaluated including pretreatment PSA, clinical stage and biopsy Gleason score. In addition, time from biopsy to the date of RP was obtained and investigated as a potential prognostic factor. The influence of the time gap between biopsy and surgery was statistically evaluated by univariate Cox regression analyses and Kaplan-Meier analyses; a multivariate Cox Modell was performed including all preoperative parameters. Relapse following RP was defined as a postoperative PSA level >0.1 ng/ml. RESULTS: Mean followup of the patients was 33 months (1-116 months). Twenty-five percent of the patients failed during that time period. Mean time gap between diagnosis and treatment was 62 days (median 54 days) ranging from 5 to 518 days. Univariate Cox regression analysis showed no significant correlation (p=0.062) of waiting time with recurrence rate. Multivariate Cox regression documented a highly significant association of PSA (p<0.001), clinical stage (p=0.001) and biopsy Gleason grade (p<0.001) but not not for time to treatment (p=0.841). In patients with high-grade cancer again no significant impact of treatment delay was found. CONCLUSION: Treatment delay in the investigated time span of a few months did not adversely affect recurrence free survival rates. Patients can be reassured that they can evaluate treatment options without compromising efficacy due to a delay in treatment.
Authors: Shivanshu Awasthi; Travis Gerke; Jong Y Park; Francis A Asamoah; Vonetta L Williams; Angelina K Fink; Rajesh Balkrishnan; David I Lee; S Bruce Malkowicz; Priti Lal; Jasreman Dhillon; Julio M Pow-Sang; Timothy R Rebbeck; Kosj Yamoah Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-11-09 Impact factor: 4.254
Authors: Mariana Andozia Morini; Roberto Lodeiro Muller; Paulo César Barbosa de Castro Junior; Rafael José de Souza; Eliney Ferreira Faria Journal: World J Urol Date: 2018-03-16 Impact factor: 4.226
Authors: Roderick C N van den Bergh; Peter C Albertsen; Chris H Bangma; Stephen J Freedland; Markus Graefen; Andrew Vickers; Henk G van der Poel Journal: Eur Urol Date: 2013-02-22 Impact factor: 20.096
Authors: M Graefen; S Ahyai; R Heuer; G Salomon; T Schlomm; H Isbarn; L Budäus; H Heinzer; H Huland Journal: Urologe A Date: 2008-03 Impact factor: 0.639
Authors: Marc Zanaty; Mansour Alnazari; Khaled Ajib; Kelsey Lawson; Mounsif Azizi; Emad Rajih; Abdullah Alenizi; Pierre-Alain Hueber; Côme Tolmier; Malek Meskawi; Fred Saad; Raisa S Pompe; Pierre I Karakiewicz; Assaad El-Hakim; Kevin C Zorn Journal: World J Urol Date: 2017-10-20 Impact factor: 4.226