Table 3.
Pathologic outcomes along the studies
| Author, publication year | Results according to definition of delay | |||||
|---|---|---|---|---|---|---|
| Anil 2018 [23] | ≤ 60 days (2 months) | 61–120 days (2–4 months) | ≥ 120 days (4 months) | |||
| EPE | Ref | OR 2.250; 95% CI 1.029–4.918; p = 0.042 | OR 0.694; 95% CI 0.206–2.341; p = 0.556 | |||
| SVI | Ref | OR 0.396; 95% CI 0.143–1.092; p = 0.073 | OR 0.162; 95% CI 0.024–1.111; p = 0.064 | |||
| PSM | Ref | OR 1.569; 95% CI 0.735–3.351; p = 0.244 | OR 1.674; 95% CI 0.509–5.513; p = 0.397 | |||
| LVI | Ref | OR 1.500; 95% CI 0.362–6.213; p = 0.576 | OR 1.640; 95% CI 0.110–24.540; p = 0.720 | |||
| Korets 2011 [24] | ≤ 60 days (2 months) | 61–90 days (2–3 months) | > 90 days (3 months) | |||
| ECE | Ref | OR 1.03; 95% CI 0.78–1.35; p = 0.84 | OR 0.95; 95% CI 0.69–1.04; p = 0.07 | |||
| SVI | Ref | OR 0.91; 95% CI 0.69–1.20; p = 0.49 | OR 0.91; 95% CI 0.62–1.11; p = 0.45 | |||
| PSM | Ref | OR 1.13; 95% CI 0.85–1.51; p = 0.38 | OR 1.06; 95% CI 0.66–1.41; p = 0.86 | |||
| LVI | Ref | OR 0.87; 95% CI 0.56–1.33; p = 0.53 | OR 0.99; 95% CI 0.59–1.68; p = 0.68 | |||
| UG | Ref | OR 1.11; 95% CI 0.83–1.48; p = 0.48 | OR 1.08; 95% CI 0.78–1.44; p = 0.96 | |||
| Aas, 2018 [25] | PSM |
≤ 60 days (2 months) IR: 29.6 HR: 27.7 |
61–90 days (2–3 months) IR: 30.4 HR: 34.4 |
91–120 days (3–4 months) IR: 23.1 HR: 33.9 |
121–180 days (4–6 months) IR: 21.1 HR: 35.7 |
p = 0.02 p = 0.46 |
| Ginsburg 2020 [20] | ≤ 3 months | 4–6 months | 7–9 months | 10–12 months | ||
| AP | Ref | OR 0.98; 95% CI 0.94–1.02; p = 0.31 | OR 1.02; 95% CI 0.91–1.13; p = 0.773 | OR 1.00; 95% CI 0.80–1.26; p = 0.98 | ||
| LVI | Ref | OR 1.02; 95% CI 0.93–1.12; p = 0.608 | OR 0.91; 95% CI 0.68–1.22; p = 0.533 | OR 1.06; 95% CI 0.65–1.74; p = 0.814 | ||
| UG | Ref | OR 1.00; 95% CI 0.95–1.05; p = 0.922 | OR 1.09; 95% CI 0.95–1.24; p = 0.228 | OR 1.06; 95% CI 0.82–1.37; p = 0.649 | ||
| Abern 2012 [9] | ≤ 3 months | 3–6 months | 6–9 months | > 9 months | ||
| ECE | Ref | NR | NR | OR 6.68, 95% CI 1.04–42.77, p = 0.045 | ||
| PSM | Ref | OR 1.01; 95% CI 0.71–1.44; p = 0.941 | OR 1.03; 95% CI 0.53–1.99; p = 0.929 | OR 4.08; 95% CI 1.52–10.91; p = 0.005 | ||
| Morini 2017 [21] | ≤ 6 months | 6–12 months | > 12 months | |||
| ECE | 9.9% | 12.1% | 10.6% | |||
| SVI | 6% | 3.8% | 2.1% | |||
| PSM | 34.1% | 33.5% | 31.2% | |||
| LVI | 2.7% | 4.3% | 2.1% | |||
| UG | 35.2% | 40.2% | 35.4% | |||
| Berg 2015 [10] | Significant increases in the proportion of adverse pathological outcomes were found beyond 60 days for patients with Gleason 7 and PSA > 20 (p = 0.032), and 30 days for patients with Gleason 8–10 and PSA 11–20 (p = 0.041) | |||||
| Diamand | 3-month delay was not significantly associated with upgrading (OR 0.98, 95% CI 0.94–1.02, p = 0.3), LNI (OR 0.88, 95% CI 0.77–1.01, p = 0.07), pathological locally advanced disease (OR 1, 95% CI 0.97–1.03, p = 0.8) | |||||
| Filippou 2015 [11] |
Immediate RP had a lower probability of adverse pathology than delayed RP > 6 months after diagnostic biopsy (OR 0.34, 95% CI 0.21–0.55) The rate of adverse pathology did not differ between immediate and delayed RP > 6 months in patients matched for pretreatment characteristics (OR 0.79, 95% CI 0.27–2.28) |
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| Gupta 2019 [22] |
There was no significant difference in rates of PSM, EPE, SVI, or LNI in men who had RP < 3 months vs. 3–6 months after diagnosis in terms of GG: GG3: PSM: 22% vs. 21%, p = 0.7; EPE: 50% vs. 48%, p = 0.6; SVI: 13% vs. 11%, p = 0.3; LNI: 6% vs. 4%, p = 0.3; GG4: PSM: 19% vs. 21%, p = 0.7; EPE: 53% vs. 46%, p = 0.2; SVI: 13% vs. 13%, p = 1.0; LNI: 7% vs. 5%, p = 0.4; GG5: PSM: 34% vs. 32%, p = 0.7; EPE: 72% vs. 74%, p = 0.8; SVI: 32% vs. 33%, p = 0.8; LNI: 19% vs. 16%, p = 0.5 |
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| Nesbitt 2020 [27] | Time between biopsy and surgery more than 90 days (3 months) was not associated with adverse outcomes (upgrading, PSM) except for pathological ECE or pT3 disease (p = 0.04) | |||||
| Patel 2019 [12] | Delays of up to 6 months were not associated with an increased risk of upgrading, ECE, SVI, PSM, or LNI | |||||
| Zakaria 2020 [16] | Cohort analysis showed correlation between CAPRA-score difference and wait time (Pearson correlation: r = − 0.062; p = 0.044) | |||||
Ap adverse pathology; CI confidential interval; ECE extracapsular extension; EPE exctraprostatic extension; GG Gleason score; HR high risk; IR intermediate risk; LNI lymph node invasion; OR odds ratio; PSM positive surgical margins; RP radical prostatectomy; SVI seminal vesicle invasion; UG upgrade