OBJECTIVE: To test the prognostic role of treatment delay in patients affected by prostate cancer (PCa). MATERIALS AND METHODS: The study included 2,653 patients treated with radical prostatectomy (RP) at a single institution between 2006 and 2011. The evaluated outcomes were biochemical recurrence (BCR) and clinical recurrence (CR). Multivariable Cox regression analysis was used to test the association between time from diagnosis to RP and oncological outcomes. Nonparametric curve fitting methods were used to graphically explore the relationship between time from diagnosis to RP and oncological outcomes. Sensitivity analyses were repeated in the subgroups of low-, intermediate-, and high-risk patients. RESULTS: At median follow-up of 56 months (interquartile range: 26, 92), 283 patients experienced BCR, and 84 patients developed CR. Median time from PCa diagnosis to surgery was 2.8 months (interquartile range: 1.6, 4.7). At multivariable Cox regression analysis, time from biopsy to RP was significantly associated with an increased risk of BCR (hazard ratio = 1.02, P = 0.0005) and CR (hazard ratio = 1.03, P = 0.0002). Using Nonparametric curve fitting methods, a significant increased risk of BCR and CR after approximately 18 months was observed. However, when sensitivity analyses were repeated according to risk groups, this effect was maintained in high-risk patients only, and such time interval was reduced to 12 months. CONCLUSIONS: Despite the overall trend on higher rate of cancer relapse after RP, the effect of treatment delay from biopsy to RP was significantly evident in high-risk patients only. Even in high-risk patients surgical treatment can be postponed safely, but not beyond the 12-month landmark.
OBJECTIVE: To test the prognostic role of treatment delay in patients affected by prostate cancer (PCa). MATERIALS AND METHODS: The study included 2,653 patients treated with radical prostatectomy (RP) at a single institution between 2006 and 2011. The evaluated outcomes were biochemical recurrence (BCR) and clinical recurrence (CR). Multivariable Cox regression analysis was used to test the association between time from diagnosis to RP and oncological outcomes. Nonparametric curve fitting methods were used to graphically explore the relationship between time from diagnosis to RP and oncological outcomes. Sensitivity analyses were repeated in the subgroups of low-, intermediate-, and high-risk patients. RESULTS: At median follow-up of 56 months (interquartile range: 26, 92), 283 patients experienced BCR, and 84 patients developed CR. Median time from PCa diagnosis to surgery was 2.8 months (interquartile range: 1.6, 4.7). At multivariable Cox regression analysis, time from biopsy to RP was significantly associated with an increased risk of BCR (hazard ratio = 1.02, P = 0.0005) and CR (hazard ratio = 1.03, P = 0.0002). Using Nonparametric curve fitting methods, a significant increased risk of BCR and CR after approximately 18 months was observed. However, when sensitivity analyses were repeated according to risk groups, this effect was maintained in high-risk patients only, and such time interval was reduced to 12 months. CONCLUSIONS: Despite the overall trend on higher rate of cancer relapse after RP, the effect of treatment delay from biopsy to RP was significantly evident in high-risk patients only. Even in high-risk patients surgical treatment can be postponed safely, but not beyond the 12-month landmark.
Authors: Lurdes Y T Inoue; Daniel W Lin; Lisa F Newcomb; Amy S Leonardson; Donna Ankerst; Roman Gulati; H Ballentine Carter; Bruce J Trock; Peter R Carroll; Matthew R Cooperberg; Janet E Cowan; Laurence H Klotz; Alexandre Mamedov; David F Penson; Ruth Etzioni Journal: Ann Intern Med Date: 2017-11-28 Impact factor: 25.391
Authors: Alessandro Tafuri; Akbar N Ashrafi; Suzanne Palmer; Aliasger Shakir; Giovanni E Cacciamani; Atsuko Iwata; Tsuyoshi Iwata; Jie Cai; Akash Sali; Chhavi Gupta; Luis G Medina; Mariana C Stern; Vinay Duddalwar; Manju Aron; Inderbir S Gill; Andre Abreu Journal: World J Urol Date: 2019-06-07 Impact factor: 4.226
Authors: Kristian D Stensland; Todd M Morgan; Alireza Moinzadeh; Cheryl T Lee; Alberto Briganti; James W F Catto; David Canes Journal: Eur Urol Date: 2020-04-09 Impact factor: 20.096
Authors: Rutvij A Khanolkar; Harvey Quon; Kundan Thind; Michael Sia; Michael Roumeliotis; Siraj Husain; Philip McGeachy; Tyler Meyer; Kevin Martell Journal: Clin Transl Radiat Oncol Date: 2021-07-01
Authors: Ekaterina Laukhtina; Reza Sari Motlagh; Keiichiro Mori; Fahad Quhal; Victor M Schuettfort; Hadi Mostafaei; Satoshi Katayama; Nico C Grossmann; Guillaume Ploussard; Pierre I Karakiewicz; Alberto Briganti; Mohammad Abufaraj; Dmitry Enikeev; Benjamin Pradere; Shahrokh F Shariat Journal: World J Urol Date: 2021-05-28 Impact factor: 4.226