Prostate cancer recurrence unaffected by delay between diagnosis, RP

The time between prostate biopsy and radical prostatectomy does not appear to have a large effect on the risk of disease recurrence, according to researchers at Memorial Sloan-Kettering Cancer Center, New York. Counseling patients on the importance of avoiding undue delay to surgery must be based on clinical judgment, particularly with respect to modifying advice based on the patient’s risk, the authors advise.

In their study, which was published in Cancer (2006; 106:576-80), the team followed 3,149 consecutive patients who underwent radical prostatectomy as initial treatment for prostate cancer within a year of diagnosis. The time between diagnosis and prostatectomy was entered as a predictor in a multivariate logistic regression model predicting biochemical disease recurrence at 3, 5, 8, and 10 years. The year the surgery was performed, disease stage, Gleason score, and PSA were used as covariates.

The researchers found no clear evidence of a significant effect of delay to diagnosis on biochemical disease recurrence. For patients treated within 6 months (96%), the odds ratio for each additional month of delay was 1.04, 1.07, 1.08, and 1.02, respectively, for 3-, 5-, 8-, and 10-year recurrence-free survival (p>.2 for all analyses). However, the authors said the 95% confidence intervals were wide and included the possibility that even a minor delay in surgery might have a large impact on the probability of recurrence.