The risk for adverse pathologic findings at the time of radical prostatectomy (RP) for prostate cancer increased during the COVID-19 pandemic, investigators reported at the 36th annual European Association of Urology congress.
Men treated with RP during the pandemic (from March 11, when the World Health Organization declared the COVID-19 outbreak a pandemic, to December 2020) were more likely to have extraprostatic disease compared with a control group of men who underwent RP during the same time period the year before, Fabio Zattoni, MD, of Academical Medical Centre Hospital, in Udine, Italy, said during an oral presentation.
Dr Zattoni reported findings on behalf of the European Association of Urology-Young Academic Urologists Urothelial Carcinoma Working Group.
On multivariable analysis, patients who underwent RP during the pandemic had significant 35% increased odds of pT3a or greater disease and 72% increased odds of node-positive disease compared with the control group. The investigators adjusted for age, PSA level at diagnosis, cT stage, International Society of Urological Pathology (ISUP) grade at biopsy, and PI-RADS score.
The investigators found no increased risk for positive surgical margins or ISUP 4-5 grade disease.
Compared with the control group, the study arm had a significant reduction in the use of magnetic resonance imaging for staging and a higher PI-RADS score.
Dr Zattoni and colleagues concluded that the COVID-19 pandemic “induced a stage migration phenomenon” among men treated with RP.
The study included 2574 patients who underwent RP at 8 European medical centers: 927 in the study group and 1647 in the control group. The study group excluded patients with metastatic disease not eligible for local treatment and those with recurrent prostate cancer after RP or radiation therapy.
The investigators observed an average 23% reduction in RP volume compared with the equivalent timespan in the previous year.
Zattoni F, Marra G, Kretschmer A, et al. Has the COVID-19 outbreak changed the way we are treating prostate cancer? An EAU-YAU prostate cancer working group multi-institutional study. Presented at: EAU 2021, July 8-12. Abstract P1147.