LESSONS FOR COVID 19 ERA: IMPACT OF DELAYS IN SURGERY ON BIOCHEMICAL
RECURRENCE-FREE SURVIVAL AND ADVERSE ONCOLOGICAL OUTCOMES IN PROSTATE
CANCER PATIENTS
Abstract
OBJECTIVE To assess the impact of the surgical delay for localized
prostate cancer (PCa) on adverse pathological features and oncological
outcomes. MATERIALS AND METHODS Patients who underwent surgery for
localized prostate cancer were included from the Turkish Urooncology
Association (TUA) Prostate Cancer database. A History of previous
treatment or active surveillance (AS) were considered as exclusion
criteria from the study. Patients were divided into two groups according
the time period between the diagnosis and surgery; less than or equal to
90 days (group 1) or longer than 90 days (group 2). Surgical pathology
results and oncological outcomes were compared between the two groups.
RESULTS A total of 2454 out of 3646 patients were assessed. Pathological
findings of the radical prostatectomy (RP) specimens were similar
between two groups. However, there was slightly more seminal vesicle
invasion in final surgical pathology in group 1 (12.9% vs. 9.3%,
respectively p=0.042). 5-year biochemical recurrence free survival times
were similar across all D’Amico risk categories between two groups. The
regression analysis demonstrated the seminal vesicle invasion as the
only factor affecting time to PSA progression in high-risk patients
(p<0.001 HR:2.51 CI: 1,58-4,45). CONCLUSION In conclusion, our
results in this large cohort suggest that surgical delay does not cause
a deterioration for prostate cancer surgical outcomes even in high-risk
group of patients. These findings may be helpful for planning the
limited healthcare resources especially in conditions like the Covid-19
pandemic where the availability and optimal use of healthcare system
resources is crucial.