Relation between Delay Time to Surgical Treatment of Prostate Cancer and Disease Recurrence Risk

• Autor(a) principal: Veloso, Denny Fabrício Magalhães
• Data de Publicação: 2024
• Outros Autores: Veloso, Denise Sena, Andrade, André Felipe Zuccolo Barragat de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Brasileira de Cancerologia (Online)
• Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/4406
• topic: Neoplasias da Próstata; Prostatectomia; Tempo para o Tratamento; Progressão da Doença; Recidiva Local de Neoplasia; Prostatic Neoplasms; Prostatectomy; Time-to-Treatment; Disease Progression; Neoplasm Recurrence, Local; Neoplasias de la Próstata; Prostatectomía; Tiempo de Tratamiento; Progresión de la Enfermedad; Recurrencia Local de Neoplasia

Introduction: There is no consensus in the literature on a reasonable delay time from diagnosis to radical prostatectomy (RP) surgery, without worsening the prognosis. Objective: To evaluate the influence of the delay on the risk of disease recurrence in patients with acinar adenocarcinoma of the prostate treated with RP. Method: Four hundred and twelve patients undergoing RP were retrospectively evaluated. Of these, 172 were excluded due to incomplete data and another 28 due to preoperative staging as high-risk prostate cancer (PSA > 10 ng/mL or Gleason score on biopsy > 7). Pre-and postoperative stagings were compared and survival analysis was performed using the Kaplan-Meier method to investigate the influence of time on discordance between pre- and postoperative stagings. Results: For the 212 patients of the sample, the average time from diagnosis to RP was 176.1 ± 120.2 days (median 145.5 days), ranging from 29 to a maximum of 798 days. The Kaplan-Meier curve indicated that the cancer worsened the longer the delay between diagnosis and surgery. Patients undergoing surgery within 60 days had an approximately 95% probability of not increasing the initial risk of recurrence. This number fell to 80%, 70% and 50% in patients operated on up to 100, 120 and 180 days, respectively. Conclusion: Delay in performing RP represents a continuous risk of relapse. The ideal time for RP is up to 60 days from prostate biopsy, as the probability of upstaging is less than 5% in this period.