Does surgical delay for radical prostatectomy affect patient pathological outcome? A retrospective analysis from a Canadian cohort

Authors

  • Marc Zanaty Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada. Division of Robotic Urology, Department of Surgery, Hôpital du Sacré Cœur de Montréal, Montreal, Quebec, Canada.
  • Mansour Alnazari Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada. Division of Robotic Urology, Department of Surgery, Hôpital du Sacré Cœur de Montréal, Montreal, Quebec, Canada.
  • Kelsey Lawson Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Mounsif Azizi Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Emad Rajih Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Abdullah Alenizi Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Pierre-Alain Hueber Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Malek Meskawi Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Cedric Lebacle Department of Urology, CHU Mondor, Assistance Publique des Hôpitaux de Paris, Université Paris-Est, Créteil, France.
  • Thierry Lebeau Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Serge Benayoun Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Pierre I. Karakiewicz Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada.
  • Assaad El-Hakim Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada. Division of Robotic Urology, Department of Surgery, Hôpital du Sacré Cœur de Montréal, Montreal, Quebec, Canada.
  • Kevin C. Zorn Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, Quebec Canada. Division of Robotic Urology, Department of Surgery, Hôpital du Sacré Cœur de Montréal, Montreal, Quebec, Canada.

DOI:

https://doi.org/10.5489/cuaj.4149

Abstract

Introduction: We sought to assess the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on final pathological outcome.

Methods: A retrospective review of RARP patient records operated between 2006 and 2015 was conducted. SWT was defined as period from prostate biopsy to surgery. Primary outcome was the impact on postoperative Cancer of the Prostate Risk Assessment (CAPRA-S) score. Patients were stratified according to D’Amico risk categories. Univariate analysis (UVA) and multivariable (MVA) analysis with a generalized linear model was used to evaluate the effect of SWT and other predictive factors on pathological outcome in individual risk group and on the overall sample.

Results: A total of 835 patients were eligible for analysis. Mean SWT was significantly different between the three D’Amico groups, with mean SWT of 180.22 days (95% confidence interval [CI] 169.03; 191.41), 159.14 days (95% CI 152.38; 165.90), and 138.96 days (95% CI 124.60; 153.33) for low-, intermediate-, and high-risk groups, respectively (p<0.001). After stratification by D’Amico risk
group, no significant association was observed between SWT and CAPRA-S score in the three risk categories on UVA and MVA. Predictors of higher CAPRA-S score in the multivariable model in the overall cohort were: older age (p=0.014), biopsy Gleason score (p<0.001), percentage of positive cores (p<0.001), and clinical stage (p<0.001).

Conclusions: In the present study evaluating SWT for RARP in a Canadian socialized system, increased delay for surgery does not appear to impact the pathological outcome. Further studies are required to evaluate the impact of wait time on biochemical recurrence-free survival, cancer-specific survival, and overall survival.

Downloads

Download data is not yet available.

Downloads

Published

2017-08-11

How to Cite

Zanaty, M., Alnazari, M., Lawson, K., Azizi, M., Rajih, E., Alenizi, A., Hueber, P.-A., Meskawi, M., Lebacle, C., Lebeau, T., Benayoun, S., Karakiewicz, P. I., El-Hakim, A., & Zorn, K. C. (2017). Does surgical delay for radical prostatectomy affect patient pathological outcome? A retrospective analysis from a Canadian cohort. Canadian Urological Association Journal, 11(8), 265–9. https://doi.org/10.5489/cuaj.4149

Issue

Section

Original Research