Introduction:
We aimed to determine the impact of delay in the treatment of prostate cancer, as those expected to occur as a result of the COVID-19 pandemic, on oncologic outcomes.
Methods:
Between January 2012 and February 2020, patients diagnosed with NCCN intermediate or high risk prostate cancer were captured in the Michigan Urological Surgery Improvement Collaborative (MUSIC) registry. Those who underwent radical prostatectomy (RP) within one year of diagnosis were included in this study. Based on time from diagnosis to RP, patients were classified into immediate (within 3 months) or delayed RP groups (3.1-6 months, 6.1-9 months, 9.1-12 months). The primary outcomes of interest were adverse pathology (AP) at RP, defined as extraprostatic extension (EPE), seminal vesical invasion (SVI), or pN1 disease, and time to biochemical recurrence (BCR, defined as postoperative PSA>=0.2). Within each risk group, multivariable regression models were performed to compare outcomes between immediate and delayed patients, controlling for patient characteristics.
Results:
Among 8355 intermediate risk patients, 5014 (60.0%), 2809 (33.6%), 382 (4.6%), and 150 (1.8%) underwent RP <3months, 3.1-6 months, 6.1-9 months, and 9.1-12 months following diagnosis, respectively. Among 2774 high risk patients, the distribution was 1977 (71.3%), 721 (26.0%), 57 (2.1%), and 19 (0.7%), respectively. For intermediate risk patients, delaying surgery up to 6 months showed no significant difference in the risk of AP with only delays of 6-9 months resulting in increased risk of AP (OR 1.31, p=0.03). Delaying surgery up to 9 months showed no significant difference in time to BCR with only delays of 9-12 months resulting in increased risk of BCR (HR 1.76, p=0.02). For high risk patients, delaying surgery up to 12 months showed no significant difference in the risk of AP; delaying surgery up to 6 months showed no significant difference in time to BCR.
Conclusion:
A delay of treatment of <6 months from the time of diagnosis was not associated with an increase in adverse pathology at RP or BCR.
Funding: Blue Cross and Blue Shield of Michigan
Image(s) (click to enlarge):
MODERATE DELAY IN RADICAL PROSTATECTOMY DOES NOT IMPACT ONCOLOGICAL OUTCOMES OF HIGH-RISK PROSTATE CANCER
Category
Prostate Cancer > Potentially Localized
Description
Poster #191
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Presented By: Colton H. Walker
Authors:
Colton H. Walker
Udit Singhal
Ji Qi
Kevin Ginsburg
Michael Cher
Brian Lane
James Montie
David Miller
Arvin George