Biopsy-to-treatment delay in prostate cancer: Postpandemic impact in a swiss national, multicenter, prospective registry.

Authors

Timon Winistoerfer, Simone Scuderi, Giorgio Gandaglia, Nicolas Arnold, Raphael Röthlisberger, Dominik Abt, Daniel Phat Nguyen, Daniel Engeler, Räto Strebel, Laila Schneidewind, George Thalmann, Beat Roth, Nicola Giudici, Swiss Urology Registry Collaborative Group

Published in

Urologic oncology. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

Surgical delays increased during the COVID-19 pandemic. The effect of treatment delay in intermediate- and high-risk prostate cancer remains uncertain. We evaluated whether biopsy-to-surgery delay influences early oncological outcomes in a large contemporary cohort.
We analyzed 6,448 intermediate- or high-risk patients from the prospective Swiss national prostatectomy registry (2020-2025). Outcomes were: PSA persistence; adverse pathology (lymph-node invasion [LNI], extracapsular extension [ECE], seminal vesicle invasion [SVI], or ISUP ≥ 4); advanced stage (LNI, ECE, or SVI). Delay was categorized as <6 weeks, 6 weeks to 3 months, 3 to 6 months, or >6 months. Multivariable logistic regression adjusted for clinical and pathological covariates was performed.
Median time from biopsy to surgery was 2.56 months (IQR 1.87-3.55). Overall, 547 patients (8.5%) experienced PSA persistence, 2,668 (41%) had adverse pathology, and 2,376 (37%) had advanced stage disease. In multivariable analyses, biopsy-to-surgery delay was not significantly associated with PSA persistence (6 weeks-3 months: OR 0.91, P = 0.5; 3-6 months: OR 0.97, P = 0.8; >6 months: OR 1.29, P = 0.2), adverse pathology (respectively, OR 0.98, P = 0.8; OR 0.97, P = 0.7; OR 1.03, P = 0.8), or advanced stage disease (respectively, OR 0.94, P = 0.6; OR 1.02, P = 0.9; OR 1.06, P = 0.8). Subgroup analyses stratified by D'Amico risk group confirmed these findings.
In this large nationwide prospective cohort, biopsy-to-surgery delay did not adversely affect pathological or early oncological outcomes. Surgical deferral of up to 6 months appears acceptable and clinically safe, with particular relevance in settings of restricted operative capacity.

PMID:
42436100
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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