Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach.

Abstract

Traditionally, urologists recommend an interval of at least 4 weeks after

prostate biopsy before radical prostatectomy. The aim of our study was to

evaluate whether the interval from prostate biopsy to radical prostatectomy

affects immediate operative outcomes, with a focus on differences in surgical

approach. The study population of 1,848 radical prostatectomy patients was

divided into two groups according to the surgical approach: open or minimally

invasive. Open group included perineal and retropubic approach, and minimally

invasive group included laparoscopic and robotic approach. The cut-off of the

biopsy-to-surgery interval was 4 weeks. Positive surgical margin status,

operative time and estimated blood loss were evaluated as endpoint parameters. In

the open group, there were significant differences in operative time and

estimated blood loss between the <4-week and >/=4-week interval subgroups, but

there was no difference in positive margin rate. In the minimally invasive group,

there were no differences in the three outcome parameters between the two

subgroups. Multivariate analysis revealed that the biopsy-to-surgery interval was

not a significant factor affecting immediate operative outcomes in both open and

minimally invasive groups, with the exception of the interval >/=4 weeks as a

significant factor decreasing operative time in the minimally invasive group. In

conclusion, performing open or minimally invasive radical prostatectomy within 4

weeks of prostate biopsy is feasible for both approaches, and is even beneficial

for minimally invasive radical prostatectomy to reduce operative time.