Surgical Delay Associated With Worse Prostatectomy Outcome

Men who meet D'Amico low-risk criteria may have worse prostatectomy outcome after delay

THURSDAY, May 26 (HealthDay News) -- Delaying radical prostatectomy by six months or more in men who meet the D'Amico low-risk criteria for prostate cancer is correlated with worse outcomes, according to a study published in the June issue of The Journal of Urology.

Daniel O'Brien, from Northwestern University in Chicago, and colleagues investigated whether delaying surgery for six months or more affected the outcome of radical prostatectomy in 1,111 men with low-risk prostate cancer. Participants all fulfilled the D'Amico low-risk criteria of clinical stage T1c/T2a, prostate-specific antigen level lower than 10 ng/ml, and biopsy Gleason score of 6 or less. The biochemical progression rates and pathological tumor features were compared between men with and without surgical delay, and predictors of biochemical progression were analyzed.

The investigators found that D'Amico low-risk patients with a surgical delay of six months or more were significantly older, had an increased proportion of African-Americans, and had a lower proportion of clinical stage T2a (versus T1). Significant correlations were seen between surgical delay of six months or more and increased risk of biochemical progression and high-grade disease at prostatectomy, and a lower progression-free survival rate. Surgical delays of six months or more correlated significantly and independently with time to biochemical progression when prostate-specific antigen and clinical stage were included in the analysis.

"In men who met the D'Amico low-risk criteria, a surgical delay of six months or more was associated with significantly worse radical prostatectomy outcomes, including more pathology upgrading and a higher rate of biochemical progression," the authors write.

Two of the study authors disclosed financial ties to the pharmaceutical and medical device industry.

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