PROSTATE cancer surgery delay of up to 6 months did not worsen early oncological or pathological outcomes in patients with intermediate and high-risk disease, according to data from a large prospective Swiss registry.
Analysis of 6,448 patients undergoing radical prostatectomy between 2020 and 2025 showed no significant association between biopsy-to-surgery interval and prostate specific antigen (PSA) persistence, adverse pathology, or advanced stage disease.
Researchers examined data from a national multicentre prospective prostatectomy registry that included patients with intermediate or high-risk prostate cancer.
The cohort consisted of 6,448 patients treated between January 2020 and April 2025.
Median age was 67 years and the median time from biopsy to surgery was 2.56 months. Of the overall population, 46% had high risk disease.
The study assessed three key outcomes: PSA persistence at 3 months following surgery, adverse pathology, and advanced stage disease.
Overall, PSA persistence occurred in 547 patients (8.5%), adverse pathology in 2,668 patients (41%), and advanced stage disease in 2,376 patients (37%).
Patients were grouped according to biopsy-to-surgery interval: less than 6 weeks, 6 weeks to 3 months, 3 to 6 months, and more than 6 months.
Multivariable analyses adjusted for relevant clinical and pathological factors found no significant differences in outcomes across delay categories.
For PSA persistence, delays of 6 weeks to 3 months, 3 to 6 months, and more than 6 months were not associated with increased risk compared with surgery within 6 weeks.
Similar findings were reported for adverse pathology and advanced stage disease.
Subgroup analyses confirmed the absence of significant associations across favourable intermediate risk, unfavourable intermediate risk, and high-risk groups.
Non-parametric modelling also showed no increase in adverse outcomes as the interval between diagnosis and surgery lengthened.
The investigators concluded that moderate treatment delays did not compromise oncological safety in this contemporary cohort.
Surgical postponement for up to 6 months appeared clinically acceptable, even among patients with high-risk disease
The findings are particularly relevant for healthcare systems facing restricted operative capacity, as experienced during and after the COVID-19 pandemic.
Researchers noted that delays beyond 6 months were relatively uncommon and involved a smaller patient subgroup, but overall results consistently indicated that biopsy-to surgery-delay was not associated with poorer early outcomes following radical prostatectomy.
Reference
Winistoerfer T et al. Biopsy-to-treatment delay in prostate cancer: Postpandemic impact in a swiss national, multicenter, prospective registry. Urol Oncol. 2026;DOI:10.1016/j.urolonc.2026.06.016
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