Has the COVID-19 Outbreak Changed Prostate Cancer Treatment?

An analysis sought to assess the impact of COVID-19 on patients treated with radical prostatectomy (RP) for prostate cancer (PCa) in terms of surgical volume, waiting list (time from biopsy to surgery), and risk of adverse pathologic findings at RP due to the selection of men with more adverse disease characteristics at final pathology.

This study comprised 2,574 patients treated with RP (927 cases and 1,647 controls) who were treated at one of eight European tertiary referral centers between March through December 2020. This cohort was compared to a control group of patients treated at the same institutions between March through December 2019. Any patients with metastatic disease who were ineligible for local treatment and recurrent prostate cancer after RP or RT were excluded from the analysis. Multivariable logistic regression analysis assessed the impact of the COVID-19 outbreak on the risk of adverse pathologic findings at RP after adjusting for confounders.

According to the results, patients who were treated during the pandemic had higher risk of extra prostatic disease (odds ratio=1.35, P=0.038) and lymph node invasion (odds ratio=1.72, P=0.048). The researchers noted that an average 23% reduction of the surgical volume with the equivalent timespan of the previous year allowed an illusory reduction of the WL after the peak gained during the first wave of COVID-19.

“Our results showed that the COVID-19 outbreak resulted in a delay in the administration of curative-intent therapies in patients with localized PCa,” the researchers concluded.