Login to Access Video or Poster Abstract: MP47-16
Sources of Funding: None

Introduction

There is a small volume of varied literature reporting on the impact of time between prostate cancer diagnosis on biopsy and definitive intervention with radical prostatectomy with regards to adverse pathological outcomes. There are considerable, and in some cases increasing, delays in treatment for patients with prostate cancer in Canada's publicly funded healthcare system. We sought to evaluate our institutional outcomes using a large multi-surgeon database.

Methods

We retrospectively reviewed 2,728 patients who underwent radical prostatectomy between 2005 and 2014. Patients were stratified according to biopsy Grade Groups and pre-operative PSA levels. Pathologic outcomes were evaluated for patients with <2 months between biopsy and surgery and then at monthly intervals of up to 6 months. Adverse pathological outcomes were defined as Gleason upgrading from biopsy, the presence of extracapsular extension (pT3a) or seminal vesicle invasion (pT3b), positive surgical margins and positive lymph node involvement. The x2 test was used for statistical analysis.

Results

In total 2310 patients met our inclusion criteria. Median time from biopsy to surgery was 83 days (range: 61-109). Grade groups 1, 2, 3, 4, 5 comprised of 906 (39.2%), 1,048 (45.4%), 231 (10%), 69 (3%) and 56 (2.4%), respectively. In total 31.8% of patients were upgraded by Grade Group on final surgical pathology. The overall positive surgical margin rates were 25% for organ confined (pT2) disease and 49.8% patients with pT3 disease. Lymph node involvement was identified in 1.5% of patients. There was no observed difference in adverse pathologic outcomes for patients in any risk category with delays of up to 6 months between biopsy and radical prostatectomy.

Conclusions

Surgical delays of up to 6 months following prostate biopsy were not associated with an increased risk of Gleason score upgrading, extracapsular extension, seminal vesicle invasion, positive surgical margins, or lymph node involvement.

Funding

None