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. 2024 Oct 17;5(12):1314-1323.
doi: 10.1002/bco2.433. eCollection 2024 Dec.

Early oncological outcomes of delayed radical prostatectomy: A prospective, international, follow-up analysis of the COVIDSurg-Cancer study

Arjun Nathan  1   2 , Chuanyu Gao  2 , Alexander Light  2   3 , Cameron Alexander  2 , Vinson Chan  2 , Kevin Gallagher  2   4 , Sinan Khadhouri  2   4 , Kevin G Byrnes  2 , Michael Ng  5 , Michael Walters  6 , Terry Hughes  6 , Rita J Perry  6 , Kelvin Okoth  6 , Laura Magill  6 , Thomas Pinkney  6 , Yuhao Zhang  7 , James Blackmur  8 , Eric Etchill  9 , Stanley Tang  1 , Damián García Escudero  10 , Alan McNeill  4 , Krishna Narahari  11 , Grant D Stewart  12 , Veeru Kasivisvanathan  1   2 ; COVIDSurg Collaborative
Affiliations

Early oncological outcomes of delayed radical prostatectomy: A prospective, international, follow-up analysis of the COVIDSurg-Cancer study

Arjun Nathan et al. BJUI Compass. .

Abstract

Objectives: The objective of this study is to compare the early oncological outcomes of delayed (>90 days) versus scheduled (≤90 days) radical prostatectomy (RP).

Patients and methods: Patients with prostate cancer due to undergo surgery between March 2020 and June 2020 who were enrolled in the COVIDSurg-Cancer international, observational study were prospectively followed up for 1 year. Time to surgery was defined as the difference between the operation date and the multi-disciplinary team decision to offer surgery. The primary outcome was the positive surgical margin (PSM) rate. Biochemical recurrence (BCR), upgradation and upstaging were secondary oncological outcomes. The Independent t-test and Mann Whitney U test were used to compare means between groups and regression models and were used to investigate factors associated with the primary outcome.

Results: Four hundred seventy-six (78.7%) patients underwent RP from 605 that were eligible. Three hundred seven (64.5%) patients underwent scheduled RP, and 169 (35.5%) underwent delayed RP. A small proportion of men (n = 35, 6.8%) did not undergo RP within the 1-year follow-up period. More men with high-risk disease (72.8%) underwent scheduled RP compared to men with intermediate-risk disease (60.2%) (p < 0.05). There was no statistically significant difference in the PSM rate between the two groups (p = 0.512). Delay in surgery was not associated with an increased PSM or BCR on univariable or multivariable analyses. There was statistically significantly greater upstaging (p < 0.05) in the delayed group but no difference in upgradation.

Conclusion: High-risk men were prioritised for surgery during the COVID-19 pandemic. Our prospective data support previous retrospective, cancer-registry evidence suggesting no adverse oncological impact after delaying RP across all risk groups. Our study is limited by the short follow-up period, and therefore, longer term conclusions cannot be drawn.

Keywords: COVID; delay; prostate cancer; radical prostatectomy; surgery.

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Conflict of interest statement

All other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of patients included in the study. MDT, multi‐disciplinary team.
See this image and copyright information in PMC

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