Has the COVID-19 outbreak changed the way we are treating prostate cancer? - An EAU - YAU Prostate Cancer Working Group multi-institutional study

TY - JOUR

T1 - Has the COVID-19 outbreak changed the way we are treating prostate cancer? - An EAU - YAU Prostate Cancer Working Group multi-institutional study

AU - Zattoni, Fabio

AU - Marra, Giancarlo

AU - Kretschmer, Alexander

AU - Preisser, Felix

AU - Tilki, Derya

AU - Kesch, Claudia

AU - Radtke, Jan Philipp

AU - Hoffmann, Nils

AU - Morlacco, Alessandro

AU - Dal Moro, Fabrizio

AU - Soeterik, Timo F W

AU - van den Bergh, Roderick C N

AU - Barletta, Francesco

AU - Briganti, Alberto

AU - Montorsi, Francesco

AU - Gandaglia, Giorgio

N1 - Copyright by Polish Urological Association.

PY - 2021

Y1 - 2021

N2 - Introduction: The COVID-19 outbreak has become the dominant issue throughout the world whilst the governments, nations and health services are trying to deal with its impact. The aim of our study is to assess the impact of COVID-19 on patients treated with radical prostatectomy (RP) for prostate cancer (PCa) at European referral centers in terms of surgical volume (SV), waiting list meant as time from biopsy to surgery (WL) and risk of adverse pathologic findings at RP due to the selection of men with more adverse disease characteristics at final pathology.Material and methods: Consecutive patients with a diagnosis of histologically proven PCa treated with RP between March 2020 (WHO declaration of pandemic) and December 2020 were identified. Patients with metastatic disease not eligible to local treatment and recurrent prostate cancer after RP or RT were excluded. Patients treated at the same institutions between March 2019 and December 2019 were considered as the control group. Multivariable logistic regression analysis tested the impact of the COVID-19 outbreak on the risk of adverse pathologic findings at RP after adjusting for confounders. The percentage change of SV and WL was assessed comparing the months of pandemic with the equivalent timespan of the previous year.Results: A total of 2,574 patients treated with RP (927 cases and 1647 controls) were identified in 8 European tertiary referral centers. At multivariable analysis patients who were treated during the pandemic had higher risk of extra prostatic disease (OR:1.35, p = 0.038) and lymph node invasion (LNI) (OR:1.72, p = 0.048). An average 23% reduction of the SV with the equivalent timespan of the previous year allowed an illusory reduction of the WL after the peak gained during the first wave of COVID-19.Conclusions: Our results showed that the COVID-19 outbreak resulted in a delay in the administration of curative-intent therapies in patients with localized PCa. This, in turn, resulted in a stage migration phenomenon with a potential impact on oncologic control.

AB - Introduction: The COVID-19 outbreak has become the dominant issue throughout the world whilst the governments, nations and health services are trying to deal with its impact. The aim of our study is to assess the impact of COVID-19 on patients treated with radical prostatectomy (RP) for prostate cancer (PCa) at European referral centers in terms of surgical volume (SV), waiting list meant as time from biopsy to surgery (WL) and risk of adverse pathologic findings at RP due to the selection of men with more adverse disease characteristics at final pathology.Material and methods: Consecutive patients with a diagnosis of histologically proven PCa treated with RP between March 2020 (WHO declaration of pandemic) and December 2020 were identified. Patients with metastatic disease not eligible to local treatment and recurrent prostate cancer after RP or RT were excluded. Patients treated at the same institutions between March 2019 and December 2019 were considered as the control group. Multivariable logistic regression analysis tested the impact of the COVID-19 outbreak on the risk of adverse pathologic findings at RP after adjusting for confounders. The percentage change of SV and WL was assessed comparing the months of pandemic with the equivalent timespan of the previous year.Results: A total of 2,574 patients treated with RP (927 cases and 1647 controls) were identified in 8 European tertiary referral centers. At multivariable analysis patients who were treated during the pandemic had higher risk of extra prostatic disease (OR:1.35, p = 0.038) and lymph node invasion (LNI) (OR:1.72, p = 0.048). An average 23% reduction of the SV with the equivalent timespan of the previous year allowed an illusory reduction of the WL after the peak gained during the first wave of COVID-19.Conclusions: Our results showed that the COVID-19 outbreak resulted in a delay in the administration of curative-intent therapies in patients with localized PCa. This, in turn, resulted in a stage migration phenomenon with a potential impact on oncologic control.

UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552935/

U2 - 10.5173/ceju.2021.0211

DO - 10.5173/ceju.2021.0211

M3 - SCORING: Journal article

C2 - 34729226

VL - 74

SP - 362

EP - 365

JO - CENT EUR J UROL

JF - CENT EUR J UROL

SN - 2080-4806

IS - 3

ER -