Nesbitt, Alexander L., Smith, Philip G., Antoniou, Stefan, Evans, Garrath A., and Pridgeon, Simon W. (2021) Delay to radical prostatectomy: who, why and does it matter? Journal Of Clinical Urology, 14 (3). pp. 207-212.

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Abstract

Objective: This study aimed to analyse a population of men undergoing radical prostatectomy to determine whether a delay to surgery is associated with poorer outcomes. A secondary aim was to analyse whether the introduction of positron emission tomography (PET) imaging using probes labelled with radiotracers targeting prostate-specific membrane antigen (PSMA) was associated with delay.

Methods: A retrospective chart review was performed for men undergoing radical prostatectomy in Cairns, Australia, between March 2014 and March 2018, who were identified from a prospectively maintained database.

Results: A total of 332 cases were analysed. Logistic regression analysis failed to show extra time between biopsy and surgery as a predictor for any adverse outcome. Patients who underwent preoperative staging with PSMA-PET had a longer delay between biopsy and imaging (47.1 +/- 40.4vs. 32.3 +/- 22.9 days;p<0.01) but a shorter duration between biopsy and surgery (109.5 +/- 64.7vs. 132.5 +/- 70.8 days,p<0.01) compared with men staged with computed tomography and a bone scan.

Conclusions: Delay to surgery was not a predictor for adverse pathological outcomes or the need for further postoperative treatment. Patients staged with PSMA-PET took longer to get their imaging but proceeded to surgery quicker overall, likely because they had a higher-risk disease.

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