Intermediate/high-risk PCa: up to 6 months' wait for surgery does not affect outcomes

  • Gupta N & al.
  • BJU Int
  • 20 Dec 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In men with unfavorable intermediate/high-risk localized prostate cancer (PCa) who underwent radical prostatectomy (RP) within 6 months, time between diagnosis and surgery does not affect outcomes.

Why this matters

  • The effect of time between diagnosis and surgery on oncologic outcomes is unclear; some guidelines recommend RP within 1 month.

Study design

  • 2303 men with Gleason grade group (GG) ≥3 PCa underwent RP within 6 months of diagnosis during 2005-2018.
  • Funding: None disclosed.

Key results

  • 54% had GG3, 26% had GG4, and 20% had GG5 disease.
  • 72% underwent RP
  • 68% men had follow-up post-RP for >1 year.
  • Patients who had RP
  • positive surgical margin (34% vs 32%; P=.7);
  • extraprostatic extension (72% vs 74%; P=.8);
  • seminal vesicle invasion (32% vs 33%; P=.8);
  • lymph node involvement (19% vs 16%; P=.5);
  • 5-year biochemical recurrence-free survival rate: GG3, 69% vs 66% (P=.6); GG4, 51% vs 57% (P=.4); GG5, 48% vs 54% (P=.2);
  • 10-year metastasis-free survival (MFS) rates: GG3, 84% vs 91% (P=.4); GG4, 72% vs 81% (P=.8); and
  • 5-year MFS rate in GG5 patients (81% vs 71%; P=.9).

Limitations

  • Retrospective design.

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