Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Braz J Urol (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300468 |
Resumo: | ABSTRACT Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease. |
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International Braz J Urol (Online) |
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Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomySurgical Procedures, OperativeProstatectomyTherapeuticsABSTRACT Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease.Sociedade Brasileira de Urologia2019-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300468International braz j urol v.45 n.3 2019reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2018.0196info:eu-repo/semantics/openAccessWesterman,Mary E.Sharma,ViditBailey,George C.Boorjian,Stephen A.Frank,IgorGettman,Matthew T.Thompson,R. HoustonTollefson,Matthew K.Karnes,Robert Jeffreyeng2019-06-18T00:00:00Zoai:scielo:S1677-55382019000300468Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2019-06-18T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false |
dc.title.none.fl_str_mv |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
title |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
spellingShingle |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy Westerman,Mary E. Surgical Procedures, Operative Prostatectomy Therapeutics |
title_short |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
title_full |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
title_fullStr |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
title_full_unstemmed |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
title_sort |
Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy |
author |
Westerman,Mary E. |
author_facet |
Westerman,Mary E. Sharma,Vidit Bailey,George C. Boorjian,Stephen A. Frank,Igor Gettman,Matthew T. Thompson,R. Houston Tollefson,Matthew K. Karnes,Robert Jeffrey |
author_role |
author |
author2 |
Sharma,Vidit Bailey,George C. Boorjian,Stephen A. Frank,Igor Gettman,Matthew T. Thompson,R. Houston Tollefson,Matthew K. Karnes,Robert Jeffrey |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Westerman,Mary E. Sharma,Vidit Bailey,George C. Boorjian,Stephen A. Frank,Igor Gettman,Matthew T. Thompson,R. Houston Tollefson,Matthew K. Karnes,Robert Jeffrey |
dc.subject.por.fl_str_mv |
Surgical Procedures, Operative Prostatectomy Therapeutics |
topic |
Surgical Procedures, Operative Prostatectomy Therapeutics |
description |
ABSTRACT Introduction: To determine the impact of time from biopsy to surgery on outcomes following radical prostatectomy (RP) as the optimal interval between prostate biopsy and RP is unknown. Material and methods: We identified 7, 350 men who underwent RP at our institution between 1994 and 2012 and had a prostate biopsy within one year of surgery. Patients were grouped into five time intervals for analysis: ≤ 3 weeks, 4-6 weeks, 7-12 weeks, 12-26 weeks, and > 26 weeks. Oncologic outcomes were stratified by NCCN disease risk for comparison. The associations of time interval with clinicopathologic features and survival were evaluated using multivariate logistic and Cox regression analyses. Results: Median time from biopsy to surgery was 61 days (IQR 37, 84). Median follow-up after RP was 7.1 years (IQR 4.2, 11.7) while the overall perioperative complication rate was 19.7% (1,448/7,350). Adjusting for pre-operative variables, men waiting 12-26 weeks until RP had the highest likelihood of nerve sparing (OR: 1.45, p = 0.02) while those in the 4-6 week group had higher overall complications (OR: 1.33, p = 0.01). High risk men waiting more than 6 months had higher rates of biochemical recurrence (HR: 3.38, p = 0.05). Limitations include the retrospective design. Conclusions: Surgery in the 4-6 week time period after biopsy is associated with higher complications. There appears to be increased biochemical recurrence rates in delaying RP after biopsy, for men with both low and high risk disease. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300468 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382019000300468 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1677-5538.ibju.2018.0196 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Urologia |
dc.source.none.fl_str_mv |
International braz j urol v.45 n.3 2019 reponame:International Braz J Urol (Online) instname:Sociedade Brasileira de Urologia (SBU) instacron:SBU |
instname_str |
Sociedade Brasileira de Urologia (SBU) |
instacron_str |
SBU |
institution |
SBU |
reponame_str |
International Braz J Urol (Online) |
collection |
International Braz J Urol (Online) |
repository.name.fl_str_mv |
International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU) |
repository.mail.fl_str_mv |
||brazjurol@brazjurol.com.br |
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1750318076817047552 |