Association between Delay to Radical Prostatectomy and Clinically Meaningful Outcomes among Patients with Intermediate and High-Risk Localized Prostate Cancer

Maggie C. Lee, Tyler R. Erickson, Shannon Stock, Lauren E. Howard, Amanda M. De Hoedt, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Martha K. Terris, Zachary Klaassen, Stephen J. Freedland, Christopher J.D. Wallis

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose:There are limited data regarding the effect of treatment delays on important long-term outcomes among men with intermediate/high-risk prostate cancer (PC).Materials and Methods:We identified 3,962 men with intermediate/high-risk disease from the SEARCH cohort treated with radical prostatectomy (RP) from 1988 to 2018. Cox proportional hazard models assessed the association between time from biopsy to RP (up to 1 year) and time to castration-resistant PC (CRPC), metastasis and all-cause mortality. Interaction terms were used to test for effect modification by risk group.Results:Of the 3,962 men, 167 developed CRPC, 248 developed metastases and 884 died after a median followup of 85 months. Longer delays between biopsy and RP were associated with a decreased risk of CRPC (adjusted HR=0.88, 95% CI: 0.80-0.98, p=0.02), independent of D'Amico risk group (interaction p >0.05). In men with intermediate and high-risk disease, we found no statistically significant association between length of time to RP and risk of developing metastases (p=0.5 and 0.9, respectively) or all-cause mortality (p=0.1 and 0.1, respectively).Conclusions:Among men with intermediate and high-risk PC, we found no statistically significant increased risk of adverse long-term outcomes, including CRPC, metastasis and death, for men who had treatment delays up to 1 year following PC diagnosis.

Original languageEnglish (US)
Pages (from-to)592-600
Number of pages9
JournalJournal of Urology
Volume207
Issue number3
DOIs
StatePublished - Mar 1 2022
Externally publishedYes

Keywords

  • COVID-19
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

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