Clinical Scorecard: Consequences of Postponing Radical Prostatectomy in Men with Intermediate to High-Risk Prostate Cancer: A Comprehensive Review
At a Glance
Category
Detail
Condition
Intermediate- and high-risk prostate cancer
Key Mechanisms
Delay in radical prostatectomy potentially impacting cancer progression and survival outcomes
Target Population
Men diagnosed with intermediate- and high-risk prostate cancer
Care Setting
Urology surgical and oncology care settings during the COVID-19 pandemic and beyond
Key Highlights
COVID-19 pandemic caused significant delays and reductions (~50%) in radical prostatectomy procedures.
Delays up to 3 months in radical prostatectomy for intermediate- and high-risk prostate cancer may not significantly impact oncological outcomes.
There is heterogeneity in defining 'delay' across studies, mostly using 2-3 month intervals to assess impact.
Guideline-Based Recommendations
Diagnosis
Timely diagnosis and risk stratification of prostate cancer to guide treatment urgency.
Use interdisciplinary team boards and precision diagnostics for individualized patient monitoring.
Management
Consider deferring radical prostatectomy only if delay is unlikely to affect cancer outcomes, especially during resource constraints like COVID-19.
Active surveillance may be appropriate for low-risk patients; intermediate- and high-risk patients require careful monitoring if treatment is delayed.
Monitoring & Follow-up
Regular monitoring of intermediate- and high-risk patients during any treatment delay to detect disease progression.
Use survival and pathologic outcomes as key measures to assess impact of deferred surgery.
Risks
Prolonged delays without monitoring in intermediate- and high-risk prostate cancer may lead to disease progression.
Resource allocation and COVID-19 transmission risks must be balanced against cancer treatment urgency.
Patient & Prescribing Data
Men with intermediate- and high-risk prostate cancer undergoing radical prostatectomy
Delays in radical prostatectomy up to 3 months have not shown significant adverse oncological outcomes in reviewed literature; longer delays require cautious evaluation.
Clinical Best Practices
Prioritize radical prostatectomy scheduling based on risk stratification and potential impact of delay on outcomes.
Implement individualized patient monitoring protocols during any treatment deferral.
Maintain multidisciplinary communication to adapt treatment plans amid healthcare system constraints.
Use evidence-based guidelines to balance COVID-19 risks with cancer treatment urgency.
by Ekaterina Laukhtina, Reza Sari Motlagh, Keiichiro Mori, Fahad Quhal, Victor M. Schuettfort, Hadi Mostafaei, Satoshi Katayama, Nico C. Grossmann, Guillaume Ploussard, Pierre I. Karakiewicz, Alberto Briganti, Mohammad Abufaraj, Dmitry Enikeev, Benjamin Pradere, Shahrokh F. Shariat
