Delayed RP Not Associated with Adverse Oncological Outcomes--Covid Implications[b]

Delayed Radical Prostatectomy is Not Associated with Adverse Oncological Outcomes: Implications for Men Experiencing Surgical Delay Due to the COVID-19 Pandemic (2020)

"Abstract
Purpose:
The 2019 Novel Coronavirus (COVID-19) pandemic has forced many healthcare organizations to divert efforts and resources to emergent patient care, delaying many elective oncological surgeries. We investigated an association between delay in radical prostatectomy (RP) and oncological outcome.

Materials and Methods:
This is a retrospective review of men with intermediate and high-risk prostate cancer (PC) in the National Cancer Database (NCDB) underdoing radical prostatectomy from 2010-2016. Immediate RP was defined as RP within 3-months of diagnosis, while delayed RP was analyzed in 3-month intervals up to 12-months. Multivariable logistic regression models were fit to test for associations between levels of delayed RP and outcomes of interest (adverse pathology, upgrading on RP, node positive disease, and post-RP secondary treatments) compared with men undergoing immediate RP.

Results:
We identified 128,062 men with intermediate- and high-risk PC treated with RP. After adjustment, we did not appreciate a significant difference in odds of adverse pathology, upgrading, node positive disease, or post-RP secondary treatments between men treated with immediate RP and any level of delay up to 12 months. Subgroup analysis of men with Grade group 4 and 5 PC did not demonstrate an association between delayed RP and worse oncological outcomes.

Conclusions:
In the NCDB, delayed RP was not associated with early adverse oncological outcomes at RP. These results may provide reassurance to patients and urologists balancing care in the current pandemic."

[Emphasis mine]

Djin

From my own feelings and experience I would want to disagree with these findings unless it involved the use of ADT at the start of any delay. I was diagnosed in Feb 2016, started on Lupron in May, surgery in Sept, and had BCR in Feb 2017, and in March this year had several new mets and started Taxotere. As a G 3+4 but T3b N1 M0 I would not have wanted any more delays than the time it normally took in scheduling appointments.
Dave