Objective: This study aimed to determine if delays to radical prostatectomy in men diagnosed with prostate cancer via transperineal biopsies correlate with adverse outcomes.
Methods: The study analyzed data from the Prostate Cancer Outcomes Registry-Victoria, focusing on men with prostate cancer of the International Society for Urological Pathology grade group ≥2, who were diagnosed by transperineal prostate biopsies and underwent prostatectomy between January 1, 2014, and June 30, 2018. The analysis examined time intervals from biopsy (28, 60, 90, 120, and 270 days) and their association with adverse outcomes, such as Gleason upgrading, early biochemical recurrence, pT3 disease at prostatectomy, and positive surgical margins.
Results:
- A total of 2008 men were analyzed.
- Adverse outcomes included:
- 306 men (16.7%) with Gleason upgrading.
- 151 men (8.4%) with biochemical recurrence.
- 1068 men (54.1%) with pT3 disease.
- 464 men (23.1%) with positive surgical margins.
- All adverse outcomes were significantly associated with higher prostate-specific antigen and grade at diagnosis.
- Delays of 120–270 days did not significantly increase the incidence of Gleason upgrading, pT3 disease, or biochemical recurrence.
- Delays were associated with positive surgical margins but not in a consistent pattern.
- Regression analysis showed no increased likelihood of most adverse outcomes for delays up to 270 days.
Conclusion: Men with prostate cancer of grade group ≥2 diagnosed through transperineal biopsy can wait up to 270 days for a prostatectomy without a greater risk of adverse outcomes such as Gleason upgrading, pT3 disease, positive surgical margins, or biochemical recurrence.
