Surgical Wait Time Is Not Associated With Oncological or Psychosocial Outcomes After Robotic Radical Prostatectomy

Area of Science:

• Urology
• Oncology
• Surgical Outcomes

Background:

• Prostate cancer (PCa) is a common male malignancy with rising incidence.
• Increasing surgical wait times (SWT) for curative surgery pose challenges, especially in public health systems.
• The impact of SWT on oncological outcomes in PCa is debated, and its effect on patient-reported outcomes is under-evaluated.

Purpose of the Study:

• To investigate the influence of SWT on oncological and psychological outcomes in patients undergoing robot-assisted radical prostatectomy (RARP).
• To assess functional outcomes and patient-reported quality of life following RARP in relation to SWT.
• To evaluate the effect of SWT on recurrence-free survival (RFS) in intermediate-risk localized PCa.

Main Methods:

• Retrospective single-center study of 218 patients undergoing RARP for intermediate-risk PCa (April 2016 - August 2024).
• Patients stratified into SWT groups: < 6 months vs. ≥ 6 months.
• Oncological outcomes (RFS, pathological features) and patient-reported outcomes (SF-36, DRS) were analyzed.

Main Results:

• No significant difference in RFS between SWT groups (p=0.98), including high-risk subgroups (p=1.00).
• No significant differences observed in pathological features like extraprostatic extension or positive surgical margins.
• Patient-reported outcomes (SF-36, DRS) showed no statistically significant differences between groups at any time point.

Conclusions:

• SWT exceeding 6 months did not adversely affect oncological outcomes in intermediate-risk PCa patients.
• Health-related quality of life and psychological well-being were not negatively impacted by longer SWT in this cohort.
• These findings suggest that extended surgical wait times may be acceptable for select intermediate-risk prostate cancer patients without compromising outcomes.