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Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence?
Article first published online: 13 DEC 2005
Copyright © 2005 American Cancer Society
Volume 106, Issue 3, pages 576–580, 1 February 2006
How to Cite
Vickers, A. J., Bianco, F. J., Boorjian, S., Scardino, P. T. and Eastham, J. A. (2006), Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence?. Cancer, 106: 576–580. doi: 10.1002/cncr.21643
- Issue published online: 20 JAN 2006
- Article first published online: 13 DEC 2005
- Manuscript Accepted: 15 AUG 2005
- Manuscript Revised: 26 JUL 2005
- Manuscript Received: 21 JUN 2005
- National Cancer Institute. Grant Number: P50-CA92629 SPORE
- Leon Lowenstein Foundation
- American Foundation for Urologic Disease
- National Institutes of Health. Grant Number: T32-82088
- prostatic neoplasms;
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).
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.
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.
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. Cancer 2006. © 2005 American Cancer Society.