Biopsy-to-RP Delay May Up Prostate Cancer Recurrence Risk
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A greater than 90-day delay from prostate biopsy to radical prostatectomy (RP) for localized prostate cancer (PCa) may increase the risk of biochemical recurrence of disease, according to study findings presented at the 33rd European Association of Urology Congress in Copenhagen, Denmark.
In a retrospective study of 513 men who underwent RP for localized PCa at a single center, Matthias Meunier, MD, and colleagues at Hôpital Foch in Suresnes, France, found a linear correlation of the delay between biopsy and RP and the risk of biochemical recurrence (BCR). Patients who delayed RP beyond 90 days had a significantly (p = 0.04) increased risk of BCR compared with men with a less than 90-day delay. The investigators used the same methodology as that used in a study published by Berg et al in The Prostate (2015;75:1085-1091).
When the investigators classified patients according to biopsy Gleason grade, the largest group of patients, those with Gleason 3+4 disease, had a significantly elevated risk of BCR after a 90-day delay from biopsy to RP. In addition, patients with Gleason 3+4 disease who had a greater than 90-day delay from biopsy to RP had a significantly increased risk of upgrading at RP. Men with Gleason 8–10 cancer who delayed RP more than 60 days from the time of biopsy also had a significantly increased risk of upgrading at RP. The investigators identified no delay threshold for men with Gleason 6 cancer.
Dr Meunier and his colleagues concluded that the maximum time from biopsy to RP should be 90 days. It could be extended for men with low-risk cancer and should be shortened for those with high-risk cancer.
Meunier M, Neuzillet Y, Radulescu C, et al. Does the delay from prostate biopsy to radical prostatectomy influence the risk of biochemical recurrence. Data presented at the 33rd European Association of Urology Congress in Copenhagen, Denmark.