OBJECTIVE To assess the impact of the surgical delay for localized prostate cancer (PCa) on adverse pathological features and oncological outcomes. MATERIALS AND METHODS Patients who underwent surgery for localized prostate cancer were included from the Turkish Urooncology Association (TUA) Prostate Cancer database. A History of previous treatment or active surveillance (AS) were considered as exclusion criteria from the study. Patients were divided into two groups according the time period between the diagnosis and surgery; less than or equal to 90 days (group 1) or longer than 90 days (group 2). Surgical pathology results and oncological outcomes were compared between the two groups. RESULTS A total of 2454 out of 3646 patients were assessed. Pathological findings of the radical prostatectomy (RP) specimens were similar between two groups. However, there was slightly more seminal vesicle invasion in final surgical pathology in group 1 (12.9% vs. 9.3%, respectively p=0.042). 5-year biochemical recurrence free survival times were similar across all D’Amico risk categories between two groups. The regression analysis demonstrated the seminal vesicle invasion as the only factor affecting time to PSA progression in high-risk patients (p<0.001 HR:2.51 CI: 1,58-4,45). CONCLUSION In conclusion, our results in this large cohort suggest that surgical delay does not cause a deterioration for prostate cancer surgical outcomes even in high-risk group of patients. These findings may be helpful for planning the limited healthcare resources especially in conditions like the Covid-19 pandemic where the availability and optimal use of healthcare system resources is crucial.
Purpose To evaluate the effect of risk factors and selected surgical methods on operative and oncological results of patients undergoing radical prostatectomy (RP) with high-risk prostate cancer (HRPC). Methods Retrospective analysis of patients, who underwent RP for HRPC from 13 urology centers between 1990 to 2019, was performed. Groups were created according to the risk factors of D’Amico classification. Patients with one risk factor were included in group 1 where group 2 consisted of patients with two or three risk factors. Results A total of 1519 patients were included in this study and 1073 (70.6%) patients assigned to group 1 and 446 (29.4%) patients to group 2. Overall (biochemical and/or clinical and/or radiological) progression rate was 12.4% in group 1 and 26.5% in group 2 (p =0.001). Surgical procedure was open RP in 844 (55.6%) patients and minimally invasive RP in 675 (44.4%) patients (laparoscopic and robot-assisted RP in 230 (15.1%) and 445 (29.3%) patients, respectively). Progression rates were similar in different types of operations (p=0.22). Progression rate was not significantly different in patients who either underwent pelvic lymph node dissection (PLND) or not in each respective group. Conclusion RP alone is an effective treatment in the majority of patients with HRPC and PLND did not affect the progression rates after RP. According to the number of preoperative high-risk features, as the number of risk factors increases, there is a need for additional treatment.