Second Department of Urology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland.
Department of Urogenital Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
Curr Oncol. 2022 Apr 15;29(4):2768-2775. doi: 10.3390/curroncol29040225.
We aimed to assess whether the ongoing course of the COVID-19 epidemic has been associated with an increased risk of adverse pathology (AP) findings in prostate cancer (PC) patients treated with radical prostatectomy (RP). We performed a retrospective data analysis which included 408 consecutive, non-metastatic, previously untreated PC patients who underwent RP in our institution between March 2020 and September 2021. Patients were divided into two equally numbered groups in regard to the median surgery date (Early Epidemic [EE] and Late Epidemic [LE]) and compared. Adverse pathology was defined as either grade group (GG) ≥ 4, pT ≥ 3a or pN+ at RP. Patients in the LE group demonstrated significantly higher rates of AP than in the EE group (61 vs. 43% overall and 50 vs. 27% in preoperative non-high-risk subgroup, both p < 0.001), mainly due to higher rates of upgrading. On multivariable analysis, consecutive epidemic week (odds ratio: 1.02, 95% confidence interval: 1.00−1.03, p = 0.009) as well as biopsy GG ≥ 2 and a larger prostate volume (mL) were associated with AP in non-high-risk patients. The study serves as a warning call for increased awareness of risk underassessment in contemporarily treated PC patients.
我们旨在评估 COVID-19 疫情的持续发展是否与接受根治性前列腺切除术 (RP) 治疗的前列腺癌 (PC) 患者的不良病理学 (AP) 发现风险增加有关。我们进行了一项回顾性数据分析，其中包括 2020 年 3 月至 2021 年 9 月期间在我们机构接受 RP 的 408 例连续、非转移性、未经治疗的 PC 患者。根据中位手术日期将患者分为两组（早期流行 [EE] 和晚期流行 [LE]）并进行比较。不良病理学定义为 GG≥4、pT≥3a 或 pN+在 RP 时。LE 组患者的 AP 发生率明显高于 EE 组（总体为 61%比 43%，术前非高危亚组为 50%比 27%，均<0.001），主要是由于升级率较高。多变量分析显示，连续流行周（比值比：1.02，95%置信区间：1.00-1.03，p=0.009）以及活检 GG≥2 和更大的前列腺体积 (mL) 与非高危患者的 AP 相关。该研究提醒人们要更加注意当前治疗的 PC 患者中风险评估不足的问题。
