Delaying Radical Prostatectomy, Cancer Screening, and Care Due to COVID-19

ABSTRACT

A retrospective analysis published in the Journal of Urology indicated that a delay of up to 12 months did not result in worse outcomes when compared with immediate surgery within 3 months of diagnosis.1 When compared with patients receiving RP within 3 months of diagnosis, patients undergoing surgery 4 to 12 months after diagnosis did not have increased odds of adverse pathology, upgrading on RP, or node-positive disease. The multivariable analysis demonstrated no significant association between surgical delay and upgrading on final specimen (OR, 0.98;95% CI, 0.94-1.02;P = .3), pathologically locally advanced disease (OR, 1.00;95% CI, 0.97-1.03;P = .8), need for adjuvant therapy (OR, 0.96;95% CI, 0.84-1.11;P = .6), or lymph node invasion (OR, 0.88;95% CI, 0.77-1.01;P = .07). While the investigators noted that most men in the study were operated on within a postdiagnosis period of close to 3 months, and they warned of extrapolating the results for much longer treatment delays, similar studies demonstrated that proposals of delays of up to 6 months for high-risk disease were reasonable, while low-and intermediate-risk groups could be delayed further.