Does the Time From Biopsy to Radical Prostatectomy Affect Gleason Score Upgrading in Patients With Clinical T1c Prostate Cancer?

Purpose: It is debated whether treatment delay worsens oncologic results in localized prostate cancer (PCa). Few studies have focused on the role of a delay between the time of biopsy and the time of surgery. Thus, we aimed to investigate the effect of the time period between biopsy and surgery on Gleason score upgrading (GSU). Materials and Methods: A total of 290 patients who underwent radical retropubic prostatectomy in Ankara Training and Research Hospital were included in the study. The biopsy Gleason score, age, total prostate-specific antigen (PSA) value, prostate volumes, and PSA density (PSAD) were analyzed in all patients. The patients were divided into two groups: patients with GSU (group 1) and patients without GSU (group 2). Variables having a p-value of <= 0.05 in the univariate analysis were selected and then evaluated by use of multivariate logistic regression models. Results were considered significant at p<0.05. Results: GSU occurred in 121 of 290 patients (41.7%). The mean age of the patients was 66.0 +/- 7.2 years in group 1 and 65.05 +/- 5.60 years in group 2 (p=0.18). The mean PSA values of groups 1 and 2 were 8.6 +/- 4.1 and 8.8 +/- 4.3 ng/dL, respectively. The mean prostate volumes of groups 1 and 2 were 43.8 +/- 14.1 and 59.5 +/- 29.8 mL, respectively. The PSAD of group 1 was significantly higher than that of group 2 (0.20 vs. 0.17, p=0.003). The mean time to surgery was shorter in group 2 ( group 1, 52.2 +/- 22.6 days; group 2, 45.3 +/- 15.5 days; p=0.004). According to the logistic regression, time from biopsy to surgery is important in the prediction of GSU. Conclusions: We suggest that the time period between biopsy and surgery is a significant factor that affects GSU in patients with clinically localized PCa.