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Does time interval between prostate biopsy and surgery affect outcomes of radical prostatectomy? A systematic review and meta-analysis

Abstract

Purpose

This study aimed at exploring whether the time interval (TI) between prostate biopsy and surgery affect the outcomes of radical prostatectomy (RP).

Methods

A comprehensive search of the PubMed, Embase, and Cochrane Library databases was conducted to identify all eligible studies. After quality assessment and date extraction, a systematic review and meta-analysis was performed.

Results

A total of 9 studies with 8579 patients were included in our meta-analysis. Pooled data showed no significant differences between groups of TI ≤ 2 weeks and > 2 weeks in operative time, estimated blood loss, transfusion rate, bilateral nerve preservation, positively surgical margin, and complications. For comparison between TI ≤ 4 and > 4 weeks, shorter TI would be associated with significantly less estimated blood loss (p = 0.045) and lower rate of bilateral nerve preservation (p = 0.002). In addition, for TI ≤ 6 versus > 6 weeks, significantly less bilateral nerve preservation (p = 0.025) and more positive surgical margin (p = 0.020) could be found in the earlier surgery group. Sensitivity analysis indicated that TI had no impact on any outcomes of robot-assisted laparoscopic radical prostatectomy (RALP).

Conclusions

As shorter TI was associated with lower rate of bilateral nerve preservation and higher rate of positive surgical margin, it would be better to perform RP with a TI of 4 or 6 weeks after biopsy. While for RALP, shorter TI did not have any impact on outcomes of RALP, It is feasible and safe to perform RALP within 2, 4, or 6 weeks.

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Author information

Jie Li: Manuscript writing, Data analysis. Qing Jiang: Manuscript editing, Data collection. Qiubo Li: Data management. Yuanfeng Zhang: Data collection. Liang Gao: Project development, Manuscript editing.

Correspondence to Liang Gao.

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The authors declare that they have no conflicts of interest.

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No ethical approval was necessary due to its exclusive use of secondary data.

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Informed consent was obtained where appropriate within the included manuscripts included in this study.

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Li, J., Jiang, Q., Li, Q. et al. Does time interval between prostate biopsy and surgery affect outcomes of radical prostatectomy? A systematic review and meta-analysis. Int Urol Nephrol (2019). https://doi.org/10.1007/s11255-019-02344-6

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Keywords

  • Biopsy
  • Meta-analysis
  • Prostate cancer
  • Prostatectomy
  • Time interval