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Does surgical delay for radical prostatectomy affect biochemical recurrence? A retrospective analysis from a Canadian cohort

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A Letter to the Editor to this article was published on 16 March 2018

Abstract

Aim

We sought to explore the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on biochemical recurrence (BCR).

Method

Retrospective review of a prospectively collected database between 2006 and 2015 was conducted on all RARP cases. SWT was defined as period from prostate biopsy to surgery. Primary outcome was the impact on BCR, which was defined as two consecutive PSA ≥ 0.2 ng/dl, or salvage external beam radiation therapy and/or salvage androgen deprivation therapy. Patients were stratified according to D’Amico risk categories. Univariable analysis (UVA) and multivariable analyses (MVA) with a Cox proportional hazards regression model were used to evaluate the effect of SWT and other predictive factors on BCR, in each D’Amico risk group and on the overall collective sample.

Results

Patients eligible for analysis were 619. Mean SWT was 153, 169, 150, and 125 days, for overall, low-, intermediate-, and high-risk patients, respectively. Multivariate analysis on the overall cohort did not show a significant relation between SWT and BCR. On subgroup analysis of D’Amico risk group, SWT was positively correlated to BCR for high-risk group (p = 0.001). On threshold analysis, cut-off was found to be 90 days. SWT did not significantly affect BCR on UVA and MVA in the low- and intermediate-risk groups.

Conclusion

Increased delay to surgery could affect the BCR, as there was a positive association in high-risk group. Further studies with longer follow-up are necessary to assess the impact of wait time on BCR, cancer specific survival and overall survival.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Montreal University, Montreal, Canada

    Marc Zanaty, Mansour Alnazari, Khaled Ajib, Kelsey Lawson, Mounsif Azizi, Emad Rajih, Abdullah Alenizi, Pierre-Alain Hueber, Côme Tolmier, Malek Meskawi, Fred Saad, Raisa S. Pompe, Pierre I. Karakiewicz, Assaad El-Hakim & Kevin C. Zorn

  2. Division of Robotic Urology, Department of Surgery, “Hôpital Sacré Coeur de Montréal”, Montreal, Canada

    Marc Zanaty, Mansour Alnazari, Khaled Ajib, Assaad El-Hakim & Kevin C. Zorn

  3. Division of Robotic Urology, Department of Surgery, “Hôpital Saint-Luc”, Montreal, Canada

    Marc Zanaty, Mansour Alnazari, Khaled Ajib & Kevin C. Zorn

Authors
  1. Marc Zanaty
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  2. Mansour Alnazari
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  4. Kelsey Lawson
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  5. Mounsif Azizi
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  6. Emad Rajih
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  7. Abdullah Alenizi
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  8. Pierre-Alain Hueber
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  10. Malek Meskawi
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  13. Pierre I. Karakiewicz
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  14. Assaad El-Hakim
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  15. Kevin C. Zorn
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Contributions

MZ: Project development, Data collection and management, Data analysis, Manuscript writing and editing. MA: Project development, Data collection and management. KA: Manuscript writing and editing. KL: Manuscript writing and editing. MA: Project development Manuscript editing. ER: Data collection and management. AA: Data collection and management. PAH: Project development Manuscript editing. CT: Manuscript editing. MM: Manuscript editing. FS: Project development, Manuscript editing. RP: Manuscript editing. PIK: Project development. AE-H: Project development, Data collection and management, Manuscript writing and editing. KCZ: Project development, Data collection and management, Manuscript writing and editing.

Corresponding author

Correspondence to Kevin C. Zorn.

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Research involving human participants and/or animals

This study is a retrospective. For this type of study formal consent is not required.

Conflict of interest

All authors have no conflict of interest to declare.

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Zanaty, M., Alnazari, M., Ajib, K. et al. Does surgical delay for radical prostatectomy affect biochemical recurrence? A retrospective analysis from a Canadian cohort. World J Urol 36, 1–6 (2018). https://doi.org/10.1007/s00345-017-2105-6

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  • DOI: https://doi.org/10.1007/s00345-017-2105-6

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