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Delaying Radical Prostatectomy: Risky or Safe?

Prostate cancer.

Patients can safely delay a radical prostatectomy for up to 180 days after diagnosis of high-risk prostate cancer, according to results of a study now published in JAMA Network Open.

Using the US National Cancer Database (NCDB), the researchers collected data on 32,184 patients with clinically localized high-risk prostate adenocarcinoma who were diagnosed between the years 2006 and 2016 and who underwent a radical prostatectomy. Patients were categorized into 5 groups according to surgical delay time (SDT), the length of time between when a patient was diagnosed and when they received the radical prostatectomy: 31 to 60 days, 61 to 90 days, 91 to 120 days, 121 to 150 days, and 151 to 180 days.

Compared with those patients who received a radical prostatectomy 31 to 60 days after diagnosis, patients with longer SDTs did not experience a higher risk of any adverse pathological outcomes. In addition, longer SDTs were not associated with a decreased overall survival compared with shorter SDTs.

"Patients face a difficult and complex decision in choosing their treatment, with varying risks for complications, quality of life, and treatment regret. Patient and partner fear and anxiety following a new diagnosis of prostate cancer have been well described in the literature and are certainly heightened during the ongoing COVID-19 pandemic with the potential delay of treatment," conclude the study authors, led by Leilei Xia, MD, a urology resident in the Department of Surgery at the Perelman School of Medicine at University of Pennsylvania. "Our data support our hypothesis that prolonged time to surgery is unlikely to have adverse effects on oncological outcomes in these men. We believe that this fills a significant gap in the current literature and facilitates a shared decision-making process, especially during the ongoing COVID-19 pandemic."

For More Information

Xia L, Talwar R, Chelluri RR, et al (2020). Surgical delay and pathological outcomes for clinically localized high-risk prostate cancer. JAMA Network Open, 3(12):e2028320. DOI:10.1001/jamanetworkopen.2020.28320

Image credit: Yale Rosen. Licensed under CC BY-SA 2.0

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