Does surgical delay for radical prostatectomy affect biochemical recurrence? A retrospective analysis from a Canadian cohort

Aim We sought to explore the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on biochemical recurrence (BCR). Method Retrospective review of a prospectively collected database between 2006 and 2015 was conducted on all RARP cases. SWT was defined as period from pros...

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Bibliographic Details
Published in:	World journal of urology Vol. 36; no. 1; pp. 1 - 6
Main Authors:	Zanaty, Marc, Alnazari, Mansour, Ajib, Khaled, Lawson, Kelsey, Azizi, Mounsif, Rajih, Emad, Alenizi, Abdullah, Hueber, Pierre-Alain, Tolmier, Côme, Meskawi, Malek, Saad, Fred, Pompe, Raisa S., Karakiewicz, Pierre I., El-Hakim, Assaad, Zorn, Kevin C.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 2018 Springer Nature B.V
Subjects:	Aged Biopsy Canada Cancer Cancer surgery Humans Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - epidemiology Nephrology Oncology Original Article Prostate Prostate cancer Prostate-Specific Antigen - blood Prostatectomy Prostatectomy - methods Prostatectomy - statistics & numerical data Prostatic Neoplasms - blood Prostatic Neoplasms - epidemiology Prostatic Neoplasms - surgery Retrospective Studies Risk groups Robotic surgery Robotic Surgical Procedures Survival Time-to-Treatment Urological surgery Urology Robot-assisted radical prostatectomy Radical prostatectomy Prostate cancer Biochemical recurrence Surgical wait time
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Summary:	Aim We sought to explore the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on biochemical recurrence (BCR). Method Retrospective review of a prospectively collected database between 2006 and 2015 was conducted on all RARP cases. SWT was defined as period from prostate biopsy to surgery. Primary outcome was the impact on BCR, which was defined as two consecutive PSA ≥ 0.2 ng/dl, or salvage external beam radiation therapy and/or salvage androgen deprivation therapy. Patients were stratified according to D’Amico risk categories. Univariable analysis (UVA) and multivariable analyses (MVA) with a Cox proportional hazards regression model were used to evaluate the effect of SWT and other predictive factors on BCR, in each D’Amico risk group and on the overall collective sample. Results Patients eligible for analysis were 619. Mean SWT was 153, 169, 150, and 125 days, for overall, low-, intermediate-, and high-risk patients, respectively. Multivariate analysis on the overall cohort did not show a significant relation between SWT and BCR. On subgroup analysis of D’Amico risk group, SWT was positively correlated to BCR for high-risk group ( p = 0.001). On threshold analysis, cut-off was found to be 90 days. SWT did not significantly affect BCR on UVA and MVA in the low- and intermediate-risk groups. Conclusion Increased delay to surgery could affect the BCR, as there was a positive association in high-risk group. Further studies with longer follow-up are necessary to assess the impact of wait time on BCR, cancer specific survival and overall survival.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0724-4983 1433-8726
DOI:	10.1007/s00345-017-2105-6