Post-Pandemic Aftermath: A Two-Year Follow-Up of the Effect of COVID-19 on Oncological Outcomes after Radical Prostatectomy for Prostate Cancer

Arch Esp Urol. 2024 Jan;77(1):43-48. doi: 10.56434/j.arch.esp.urol.20247701.6.

Abstract

Purpose: This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period.

Methods: We analysed data from 423 patients who underwent radical prostatectomy between 2016 and 2022, with a cut-off date of March 16, 2020. Patients were categorised into two groups, namely, pre-lockdown (n = 289) and during lockdown (n = 134). Perioperative variables, histopathological findings and oncological outcomes, including prostate-specific antigen (PSA) levels and biochemical recurrence (BCR), were assessed.

Results: The number of radical prostatectomy increased by 24.26% during lockdown. The study included patients with a mean follow-up of 21 months. A nonsignificant trend towards a higher PSA level at presentation was found (14.22 vs. 12.53 ng/dL, p = 0.216). The International Society of Urological Pathology grade was not significantly different among radical prostatectomy specimens (p = 0.669). Lymph node involvement increased during the COVID-19 period (p = 0.046). The pT classification in prostatectomy specimens increased during the pandemic, but the difference from the pre-pandemic value was not statistically significant. The BCR rates were 24.6% pre-lockdown and 29.9% during lockdown (p = 0.136).

Conclusions: The COVID-19 pandemic led to poor postoperative results. Through a 2-year follow-up, this research investigated the effect of the pandemic on the oncological outcomes, particularly BCR, of patients who underwent radical prostatectomy. Further extended investigations and multi-institutional studies should be conducted to quantify the effect of the pandemic on various cancer outcomes and inform crisis management strategies.

Keywords: COVID; lockdown; oncological outcomes; prostatectomy.

MeSH terms

  • COVID-19* / epidemiology
  • Communicable Disease Control
  • Follow-Up Studies
  • Humans
  • Male
  • Neoplasm Recurrence, Local
  • Pandemics
  • Prostate-Specific Antigen
  • Prostatectomy / methods
  • Prostatic Neoplasms* / epidemiology
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / surgery
  • Retrospective Studies

Substances

  • Prostate-Specific Antigen