Delayed surgery after prostate biopsy does not increase recurrence risk

After a positive biopsy for prostate cancer, radical prostatectomy does not need to be performed immediately, at least as far as the risk of biochemical recurrence is concerned, according to a report in the October issue of BJU International.

“Most surgeons prefer to wait a minimum of 2 months after the biopsy before surgery to allow the post-biopsy inflammation to resolve,” Dr. James A. Eastham from Memorial Sloan-Kettering Cancer Center, New York told Reuters Health. “Such a wait does not influence outcomes and is not concerning.” Dr. Eastham and associates examined data on nearly 4000 consecutive patients who underwent radical prostatectomy within a year of the diagnosis of prostate cancer In multivariate analyses, the time from biopsy to radical prostatectomy did not predict biochemical recurrence, either when evaluated as a continuous variable or when tested as a dichotomous variable divided at 3 months, the team reports.Similarly, in a separate analysis of patients considered at a high risk of biochemical recurrence, the time to radical prostatectomy did not predict biochemical recurrence after surgery. “Most patients will not delay longer than 6 months if they are considering immediate treatment,” Dr. Eastham pointed out. “However, some men opt for watchful waiting (active surveillance) but will eventually undergo treatment months to years after their original diagnosis.” Dr. Eastham said that studies will continue to follow these men to determine whether waiting influences outcomes, including recurrence after eventual surgery. “Take time to gather the information needed to make an informed decision about what is best for the patient based on their individual cancer, age and health, and preferences,” Dr. Eastham advised. “Taking the time to gather this information will not have a negative impact on outcomes.” (Source: BJU International 2005;96:773-776: Reuters Health: Will Boggs, MD: Oncolink: October 2005.)