You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy VI (MP64)1 Sep 2021MP64-15 ASSOCIATION BETWEEN DELAY TO SURGERY AND CLINICALLY MEANINGFUL OUTCOMES AMONG PATIENTS WITH INTERMEDIATE- AND HIGH-RISK LOCALIZED PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY: AN ASSESSMENT OF THE SEARCH DATABASE WITH INSIGHT INTO THE ROLE OF NEOADJUVANT ANDROGEN DEPRIVATION THERAPY Maggie C. Lee, Tyler R. Erikson, Shannon Stock, Lauren E. Howard, Christopher L. Amling, William J. Aronson, Matthew R. Cooperberg, Christopher J. Kane, Martha K. Terris, Zachary Klaassen, Stephen J. Freedland, and Christopher J. D. Wallis Maggie C. LeeMaggie C. Lee More articles by this author , Tyler R. EriksonTyler R. Erikson More articles by this author , Shannon StockShannon Stock More articles by this author , Lauren E. HowardLauren E. Howard More articles by this author , Christopher L. AmlingChristopher L. Amling More articles by this author , William J. AronsonWilliam J. Aronson More articles by this author , Matthew R. CooperbergMatthew R. Cooperberg More articles by this author , Christopher J. KaneChristopher J. Kane More articles by this author , Martha K. TerrisMartha K. Terris More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , Stephen J. FreedlandStephen J. Freedland More articles by this author , and Christopher J. D. WallisChristopher J. D. Wallis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002104.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The effect of treatment delays for men with prostate cancer (PC) is unclear: in particular, there are limited data regarding important long-term outcomes among men with intermediate/high-risk disease. Further, in the current pandemic, some guidelines have recommended neoadjuvant androgen deprivation therapy (nADT) during treatment delays while others have rejected this approach. METHODS: We identified 4072 men (3962 hormone naïve and 110 who received neoadjuvant ADT) with intermediate- or high-risk disease from the SEARCH cohort treated with radical prostatectomy (RP) from 1988-2018. Cox proportional hazard models assessed the association between time from biopsy to RP and time to CRPC, metastasis, and all-cause mortality. Interaction terms were used to test for effect modification by risk group and use of nADT. RESULTS: Among 3962 hormone naïve patients, 167 (4.2%) developed CRPC, 248 (6.3%) men developed metastases and 884 (22%) died. We observed a small protective effect of delays between biopsy and RP on CRPC in both the univariable (HR=0.89, 95% CI: 0.80-0.97, p=0.009) and multivariable model (HR=0.88, 95% CI: 0.80-0.98, p=0.02), independent of risk group (interaction p>0.05). We found no statistically significant association between length of time to surgery and risk of developing metastases in either model (p=0.49 and 0.85), again with no significant difference in risk group (p>0.05). Finally, we found evidence of effect modification on the association between time to RP and all-cause mortality (p=0.009 and 0.027 in univariable and multivariable models, respectively). However, after multivariable adjustment, time to RP was not significantly associated with the risk of all-cause mortality in either the intermediate- (HR=0.96, 95% CI: 0.92-1.01, p=0.12) or high-risk (HR 1.05, 95% CI 0.99-1.11, p=0.12) cohorts. Use of nADT did not significantly modify the relationship between treatment delays and any of the examined outcomes (all p≥0.69). CONCLUSIONS: Among men with intermediate- and high-risk prostate cancer, treatment delays do not appear to be associated with long-term outcomes including CRPC, metastasis, and death. Further, nADT does not appear to confer benefit in this setting. Source of Funding: Support for this study was provided by the NIH/NCI under Award Number R01CA231219 and NIH K24 CA160653 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1116-e1116 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maggie C. Lee More articles by this author Tyler R. Erikson More articles by this author Shannon Stock More articles by this author Lauren E. Howard More articles by this author Christopher L. Amling More articles by this author William J. Aronson More articles by this author Matthew R. Cooperberg More articles by this author Christopher J. Kane More articles by this author Martha K. Terris More articles by this author Zachary Klaassen More articles by this author Stephen J. Freedland More articles by this author Christopher J. D. Wallis More articles by this author Expand All Advertisement Loading ...