Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence?

Andrew J. Vickers, Fernando J. Bianco, Stephen Boorjian, Peter T. Scardino, James A. Eastham

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

BACKGROUND. Men diagnosed with clinically localized prostate carcinoma have several treatment options. The investigation of these options may delay the initiation of definitive therapy. In the current study, the authors evaluated whether time from biopsy to radical prostatectomy (RP) was predictive of postoperative biochemical disease recurrence (BCR). METHODS. A total of 3149 consecutive patients who underwent RP as their initial treatment for prostate carcinoma within a year of diagnosis were identified. The time between diagnosis and RP was entered as a predictor in a multivariate logistic regression model predicting BCR at 3 years, 5 years, 8 years, and 10 years. The year surgery was performed and the nomogram-predicted probability of recurrence, which incorporates stage of disease, Gleason grade, and prostate-specific antigen (PSA) level, were used as covariates. RESULTS. The authors found no clear evidence of a significant effect of delay to diagnosis on BCR. For those patients treated within 6 months (96% of the total sample) the odds ratio for each additional month of delay was 1.04, 1.07, 1.08, and 1.02, respectively, for 3-year, 5-year, 8-year, and 10-year BCR-free survival (P > 0.2 for all analyses). However, the 95% confidence intervals were wide and included the possibility that even a minor delay in surgery might have a large impact on the probability of BCR. CONCLUSIONS. The time between biopsy and surgery does not appear to have a large effect on the risk of disease recurrence. Counseling patients on the importance of avoiding undue delay to surgery must be based on clinical judgment, particularly with respect to modifying advice based on the patient's risk.

Original languageEnglish (US)
Pages (from-to)576-580
Number of pages5
JournalCancer
Volume106
Issue number3
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

Fingerprint

Prostatectomy
Recurrence
Prostate
Logistic Models
Carcinoma
Biopsy
Nomograms
Prostate-Specific Antigen
Disease-Free Survival
Counseling
Therapeutics
Odds Ratio
Confidence Intervals

Keywords

  • Diagnosis
  • Pathology
  • Prostatectomy
  • Prostatic neoplasms
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Vickers, A. J., Bianco, F. J., Boorjian, S., Scardino, P. T., & Eastham, J. A. (2006). Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence? Cancer, 106(3), 576-580. https://doi.org/10.1002/cncr.21643

Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence? / Vickers, Andrew J.; Bianco, Fernando J.; Boorjian, Stephen; Scardino, Peter T.; Eastham, James A.

In: Cancer, Vol. 106, No. 3, 01.02.2006, p. 576-580.

Research output: Contribution to journalArticle

Vickers, AJ, Bianco, FJ, Boorjian, S, Scardino, PT & Eastham, JA 2006, 'Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence?', Cancer, vol. 106, no. 3, pp. 576-580. https://doi.org/10.1002/cncr.21643
Vickers, Andrew J. ; Bianco, Fernando J. ; Boorjian, Stephen ; Scardino, Peter T. ; Eastham, James A. / Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence?. In: Cancer. 2006 ; Vol. 106, No. 3. pp. 576-580.
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AB - BACKGROUND. Men diagnosed with clinically localized prostate carcinoma have several treatment options. The investigation of these options may delay the initiation of definitive therapy. In the current study, the authors evaluated whether time from biopsy to radical prostatectomy (RP) was predictive of postoperative biochemical disease recurrence (BCR). METHODS. A total of 3149 consecutive patients who underwent RP as their initial treatment for prostate carcinoma within a year of diagnosis were identified. The time between diagnosis and RP was entered as a predictor in a multivariate logistic regression model predicting BCR at 3 years, 5 years, 8 years, and 10 years. The year surgery was performed and the nomogram-predicted probability of recurrence, which incorporates stage of disease, Gleason grade, and prostate-specific antigen (PSA) level, were used as covariates. RESULTS. The authors found no clear evidence of a significant effect of delay to diagnosis on BCR. For those patients treated within 6 months (96% of the total sample) the odds ratio for each additional month of delay was 1.04, 1.07, 1.08, and 1.02, respectively, for 3-year, 5-year, 8-year, and 10-year BCR-free survival (P > 0.2 for all analyses). However, the 95% confidence intervals were wide and included the possibility that even a minor delay in surgery might have a large impact on the probability of BCR. CONCLUSIONS. The time between biopsy and surgery does not appear to have a large effect on the risk of disease recurrence. Counseling patients on the importance of avoiding undue delay to surgery must be based on clinical judgment, particularly with respect to modifying advice based on the patient's risk.

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