Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy
Int. braz. j. urol
;
45(3): 468-477, May-June 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1012330
ABSTRACT
ABSTRACT Introduction:
To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material andmethods:
We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals foranalysis:
≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses.Results:
Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR 3.38, p = 0.05). Limitations include the retrospective design.Conclusions:
Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Postoperative Complications
/
Prostatectomy
/
Prostatic Neoplasms
/
Time-to-Treatment
/
Intraoperative Complications
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2019
Type:
Article
Affiliation country:
United States
Institution/Affiliation country:
Mayo Clinic/US
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