Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence? Journal Article
| Authors: | Vickers, A. J.; Bianco, F. J. Jr; Boorjian, S.; Scardino, P. T.; Eastham, J. A. |
| Article Title: | Does a delay between diagnosis and radical prostatectomy increase the risk of disease recurrence? |
| Abstract: | BACKGROUND. Men diagnosed with clinically localized prostate carcinoma have several treatment options. The investigation of these options may delay the initiation of definitive therapy. In the current study, the authors evaluated whether time from biopsy to radical prostatectomy (RP) was predictive of postoperative biochemical disease recurrence (BCR). METHODS. A total of 3149 consecutive patients who underwent RP as their initial treatment for prostate carcinoma within a year of diagnosis were identified. The time between diagnosis and RP was entered as a predictor in a multivariate logistic regression model predicting BCR at 3 years, 5 years, 8 years, and 10 years. The year surgery was performed and the nomogram-predicted probability of recurrence, which incorporates stage of disease, Gleason grade, and prostate-specific antigen (PSA) level, were used as covariates. RESULTS. The authors found no clear evidence of a significant effect of delay to diagnosis on BCR. For those patients treated within 6 months (96% of the total sample) the odds ratio for each additional month of delay was 1.04, 1.07, 1.08, and 1.02, respectively, for 3-year, 5-year, 8-year, and 10-year BCR-free survival (P > 0.2 for all analyses). However, 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 BCR. CONCLUSIONS. The time between biopsy and surgery does not appear to have a large effect on the risk of disease recurrence. 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. © 2005 American Cancer Society. |
| Keywords: | survival; adult; cancer survival; treatment outcome; aged; middle aged; survival rate; major clinical study; cancer recurrence; cancer risk; united states; cancer staging; outcome assessment; neoplasm staging; medical decision making; prostate specific antigen; neoplasm recurrence, local; risk factors; recurrence; pathology; prediction; risk factor; biopsy; time factors; risk assessment; confidence interval; gleason score; prostate-specific antigen; prostatic neoplasms; survival time; probability; prostatectomy; diagnosis; outcomes research; multivariate analysis; regression analysis; nomogram; patient counseling; prostate carcinoma |
| Journal Title: | Cancer |
| Volume: | 106 |
| Issue: | 3 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2006-02-01 |
| Start Page: | 576 |
| End Page: | 580 |
| Language: | English |
| DOI: | 10.1002/cncr.21643 |
| PUBMED: | 16353213 |
| PROVIDER: | scopus |
| PMCID: | PMC1774862 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 13" - "Export Date: 4 June 2012" - "CODEN: CANCA" - "Source: Scopus" |
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