Vynbal said...Is time from diagnosis to radical prostatectomy associated with oncological outcomes?
...So how long did you take to make a decision?
In 5163 eligible patients, the median time from diagnosis to RP was 93 days (range 1–180). Risk group distribution was similar in all RP-interval groups. With almost eight years of observation, no association was found between RP-interval and PCSM in the intermediate-or high-risk groups. Increasing RP-interval did not increase the rate of adverse histological outcomes or incidence of RP-failure.
Increasing RP-interval up to 180 days was not associated with adverse oncological outcomes at eight years follow-up. These findings should be considered when planning for prostatectomy."Does the Time Interval from Biopsy to Radical Prostatectomy Affect the Postoperative Oncologic Outcomes in Korean Men?
"Conclusion: Time interval ≥ 100 days from biopsy to RP in clinically localized PC increased the
risk of pathologic upgrading but did not affect long-term BCR-free survival rates in Korean men."Time between diagnosis and surgical treatment on pathological and clinical outcomes in prostate cancer: does it matter?
"Results: A total of 908 PC patients underwent RP between 2006 and 2014. Mean age was 61.5 years, the mean time-to-surgery was 191 days (> 6 months) and 187 (20.5%) patients had BCR, with a mean follow-up of 44 months. According to our analysis, no statistically significant maximum cut-off time interval between diagnostic biopsy and surgery could be established (p = 0.215). Regardless of interval-time: ≤ 6 months (56.5%), 6-12 months (38.5%), and > 12 months (5.1%) after biopsy, we found no time interval correlated with poor oncological outcomes. This study has several limitations. It was retrospective and had a mean follow-up of 4 years. Additional follow-up is necessary to determine whether these findings will be maintained over time."Evaluating the effect of time from prostate cancer diagnosis to radical prostatectomy on cancer control: Can surgery be postponed safely?
Despite the overall trend on higher rate of cancer relapse after RP, the effect of treatment delay from biopsy to RP was significantly evident in high-risk patients only. Even in high-risk patients surgical treatment can be postponed safely, but not beyond the 12-month landmark."Research in radiation oncology and the Covid-19 pandemic
"In prostate cancer, delay of radiotherapy and use of the shortest safe regimen (ultra- or moderately hypofractionated radiotherapy) are recommended for relevant risk-groups ."
Regarding surgery, if it were me, I would feel comfortable up to about
3-4 months after diagnosis for lower risk, and perhaps 2 months after diagnosis for high risk. The caveat is that you can't be 100% certain your biopsy hasn't missed a higher-grade lesion if you are low/intermediate risk
(i.e. you might be upgraded if you chose surgery). I had a G10 biopsy and decided quickly that I wanted surgery, so there was no reason to delay. Surgeons generally (including mine) want a minimum of a 4 weeks after the biopsy for the prostate to heal, and, with the quickest scheduling of my imaging and surgery, it was 5 weeks for me between diagnosis and my RP. I haven't seen many studies on the diagnosis-to-treatment time for men choosing RT.