The effect of time from biopsy to radical prostatectomy on adverse pathologic outcomes

Abstract

Premal Patel,1 Ryan Sun,1 Benjamin Shiff,1 Kiril Trpkov,2 Geoffrey Thomas Gotto3 1Section of Urology, University of Manitoba, Winnipeg, MB, Canada; 2Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada; 3Department of Surgery, University of Calgary, Calgary, AB, Canada Objective: To assess the impact of time between prostate cancer diagnosis on biopsy and definitive intervention with radical prostatectomy (RP) in regard to adverse pathologic outcomes using a large multi-surgeon database.Materials and methods: We retrospectively reviewed 2,728 patients who underwent RP between 2005 and 2014. Patients were stratified according to biopsy Grade Group (GG). Pathologic outcomes were evaluated for patients with  Results: In total 2,310 patients met the inclusion criteria. Median time from biopsy to surgery was 83 days (range: 61–109 days). No difference was observed for patients in any risk category regarding the adverse pathologic outcomes, including GG upgrade from biopsy to prostatectomy, presence of EPE, SVI, positive surgical margins, and positive lymph node involvement, with delays of up to 6 months between biopsy and RP. Surgical margins were positive in 25% of cases with pT2 disease and 50.2% of cases with pT3 and greater disease. EPE and SVI were present in 24.5% and 7.5% of specimens, respectively.Conclusion: Surgical delays of up to 6 months following prostate biopsy were not associated with an increased risk of GG upgrading, EPE, SVI, positive surgical margins, or lymph node involvement. Keywords: radical prostatectomy, prostate cancer, surgical wait time, surgical delay, pathologic outcomes, prostate biopsy

Keywords

• Radical prostatectomy
• Prostate cancer
• Surgical wait time
• Surgical delay
• Pathologic outcomes