According to a study published in 2020, prostate cancer surgery for patients with high-risk disease can be safely delayed up to six months following diagnosis.
Because of the COVID-19 pandemic there have been widespread delays in medical treatments, including for cancer. The delays in surgery for low-risk prostate cancer have been found to result in minimal harm to the patient.
Unfortunately, however, there has been a lack of data regarding the association between surgical delay time with clinical outcomes in patients with localized, high-risk prostate cancer.
In this recent study, researchers used data from the US National Cancer Database to identify 32,184 patients with clinically localized high-risk prostate adenocarcinoma who were diagnosed between 2006 and 2016 and who received radical prostatectomy, or the removal of the prostate gland and surrounding tissues.
The surgery delay time (SDT) was defined as the number of days between initial cancer diagnosis and prostate cancer surgery, and was categorized into five groups: 31-60, 61-90, 91-120, 121-150, and 151-180 days. The primary outcomes were adverse pathological outcomes following surgery, including pT3-T4 disease, pN-positive disease, and positive surgical margin. The secondary outcome was overall survival.
When compared with an SDT of 31 to 60 days, longer SDTs were not associated with higher risks of any adverse outcomes (odds ratio 0.95; 95% confidence interval [CI] 0.80-1.12; P=0.53). An SDT of 151 to 180 was not associated with worse overall survival (hazard ratio 1.12; 95% CI 0.79-1.59; P=0.53). These same researchers also performed subgroup analysis for patients with very high-risk disease and found similar results.
The conclusion that the researchers reached was that in this large, contemporary cohort study of 32,184 patients with clinically high-risk localized prostate cancer who underwent radical prostatectomy within 180 days of diagnosis, increased SDT was not associated with higher risks of adverse pathological features or lower OS. Therefore, they concluded that radical prostatectomy for high-risk prostate cancer could be safely delayed up to 6 months after diagnosis.