Post-Pandemic Aftermath: A Two-Year Follow-Up of the Effect of COVID-19 on Oncological Outcomes after Radical Prostatectomy for Prostate Cancer.

PURPOSE

This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period.

METHODS

We analysed data from 423 patients who underwent radical prostatectomy between 2016 and 2022, with a cut-off date of March 16, 2020. Patients were categorised into two groups, namely, pre-lockdown (n = 289) and during lockdown (n = 134). Perioperative variables, histopathological findings and oncological outcomes, including prostate-specific antigen (PSA) levels and biochemical recurrence (BCR), were assessed.

RESULTS

The number of radical prostatectomy increased by 24.26% during lockdown. The study included patients with a mean follow-up of 21 months. A nonsignificant trend towards a higher PSA level at presentation was found (14.22 vs. 12.53 ng/dL, = 0.216). The International Society of Urological Pathology grade was not significantly different among radical prostatectomy specimens ( = 0.669). Lymph node involvement increased during the COVID-19 period ( = 0.046). The pT classification in prostatectomy specimens increased during the pandemic, but the difference from the pre-pandemic value was not statistically significant. The BCR rates were 24.6% pre-lockdown and 29.9% during lockdown ( = 0.136).

CONCLUSIONS

The COVID-19 pandemic led to poor postoperative results. Through a 2-year follow-up, this research investigated the effect of the pandemic on the oncological outcomes, particularly BCR, of patients who underwent radical prostatectomy. Further extended investigations and multi-institutional studies should be conducted to quantify the effect of the pandemic on various cancer outcomes and inform crisis management strategies.