Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy

Mary E. Westerman, Vidit Sharma, George C. Bailey, Stephen A. Boorjian, Igor Frank, Matthew T. Gettman, R. Houston Thompson, Matthew K. Tollefson, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median followup after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12- 26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.

Original languageEnglish (US)
Pages (from-to)468-477
Number of pages10
JournalInternational Braz J Urol
Volume45
Issue number3
DOIs
StatePublished - May 1 2019

Fingerprint

Prostatectomy
Biopsy
Prostate
Recurrence
Logistic Models
Regression Analysis
Survival

Keywords

  • Operative
  • Prostatectomy
  • Surgical procedures
  • Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy. / Westerman, Mary E.; Sharma, Vidit; Bailey, George C.; Boorjian, Stephen A.; Frank, Igor; Gettman, Matthew T.; Thompson, R. Houston; Tollefson, Matthew K.; Karnes, Robert Jeffrey.

In: International Braz J Urol, Vol. 45, No. 3, 01.05.2019, p. 468-477.

Research output: Contribution to journalArticle

Westerman, ME, Sharma, V, Bailey, GC, Boorjian, SA, Frank, I, Gettman, MT, Thompson, RH, Tollefson, MK & Karnes, RJ 2019, 'Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy', International Braz J Urol, vol. 45, no. 3, pp. 468-477. https://doi.org/10.1590/S1677-5538.IBJU.2018.0196
Westerman, Mary E. ; Sharma, Vidit ; Bailey, George C. ; Boorjian, Stephen A. ; Frank, Igor ; Gettman, Matthew T. ; Thompson, R. Houston ; Tollefson, Matthew K. ; Karnes, Robert Jeffrey. / Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy. In: International Braz J Urol. 2019 ; Vol. 45, No. 3. pp. 468-477.
@article{33d9a99db8bc42aa9bed0151cafdeecd,
title = "Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy",
abstract = "Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median followup after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7{\%} (1,448/7,350). Adjusting for pre-operative variables, men waiting 12- 26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.",
keywords = "Operative, Prostatectomy, Surgical procedures, Therapeutics",
author = "Westerman, {Mary E.} and Vidit Sharma and Bailey, {George C.} and Boorjian, {Stephen A.} and Igor Frank and Gettman, {Matthew T.} and Thompson, {R. Houston} and Tollefson, {Matthew K.} and Karnes, {Robert Jeffrey}",
year = "2019",
month = "5",
day = "1",
doi = "10.1590/S1677-5538.IBJU.2018.0196",
language = "English (US)",
volume = "45",
pages = "468--477",
journal = "International braz j urol : official journal of the Brazilian Society of Urology",
issn = "1677-5538",
publisher = "Brazilian Society of Urology",
number = "3",

}

TY - JOUR

T1 - Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy

AU - Westerman, Mary E.

AU - Sharma, Vidit

AU - Bailey, George C.

AU - Boorjian, Stephen A.

AU - Frank, Igor

AU - Gettman, Matthew T.

AU - Thompson, R. Houston

AU - Tollefson, Matthew K.

AU - Karnes, Robert Jeffrey

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median followup after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12- 26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.

AB - Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median followup after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12- 26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.

KW - Operative

KW - Prostatectomy

KW - Surgical procedures

KW - Therapeutics

UR - http://www.scopus.com/inward/record.url?scp=85067276127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067276127&partnerID=8YFLogxK

U2 - 10.1590/S1677-5538.IBJU.2018.0196

DO - 10.1590/S1677-5538.IBJU.2018.0196

M3 - Article

C2 - 30676305

AN - SCOPUS:85067276127

VL - 45

SP - 468

EP - 477

JO - International braz j urol : official journal of the Brazilian Society of Urology

JF - International braz j urol : official journal of the Brazilian Society of Urology

SN - 1677-5538

IS - 3

ER -