Page 53 - CUA 2020_Onco_Prostate

Moderated Posters 4: Prostate Cancer I

MP-4.12. Table 1. Correlation between NLR and adverse pathology at RRP
NLR ≤3.5 NLR >3.5 Mean NLR OR p Adjusted* OR Adjusted* p
n (%) n (%) (SD (95% CI) (95% CI)
Upgraded at RRP
Yes (n=161) 115 (71.4) 46 (28.6) 3.25 (3.21) 1.94 (1.27–2.94) 0.0020 1.74 (1.07–2.86) 0.027
No (n=462) 383 (82.9) 79 (17.1) 2.67 (1.14)
Extraprostatic extension
Yes (n=271) 197 (72.7) 74 (27.3) 3.04 (1.29) 1.90 (1.31–2.76) <0.001 2.41 (1.60–3.62) <0.0001
No (n=418) 349 (83.5) 69 (16.5) 2.69 (2.20)
Positive margins
Yes (n=213) 169 (79.3) 44 (20.7) 2.82 (1.23) 1.01 (0.67–1.50) 0.95 1.06 (0.70–1.59) 0.76
No (n=479) 381 (79.5) 98 (20.5) 2.82 (2.16)
Seminal vesicle
involvement
Yes (n=97) 61 (62.9) 36 (37.1) 3.39 (1.27) 2.76 (1.72–4.36) <0.0001 3.95 (2.33–6.71) <0.0001
No (n=601) 495 (82.4) 106 (17.6) 2.75 (1.98)
Nodal stage
pN+ (n=27) 20 (74.1) 7 (15.9) 3.19 (1.11) 1.41 (0.54–3.26) 0.44 1.59 (0.58–4.00) 0.34
pN- (n=634) 508 (80.1) 126 (19.9) 2.81 (1.94)
*Values adjusted for PSA, initial Gleason score, and clinical T stage at diagnosis in a multivariable logistic regression model.
MP-4.13 Results: A total of 1057 men were included for analysis. Consistent over
Impact of surgical wait times during summer months on a 10-year period, analysis of mean surgical/operative booking volumes
the oncological outcomes following robotic-assisted radical revealed that summer months had the lowest surgical volumes output
prostatectomy: 10 years’ experience from a large Canadian despite above-average booking volumes. The lowest surgical volume
academic center occurred during July (7.1 case/month), which was 35% less than the
Ahmed S. Zakaria Ahmed , Félix Couture , David-Dan Nguyen , Hanna cohort average. Moreover, summer months had the longest average time
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Shahine , Côme Tholomier , Cristina Negrean , Kyle Law , Pierre between surgical booking date and RARP, with the longest wait occur-
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Karakiewicz , Assaad El-Hakim , Kevin C. Zorn 1 ring for patients booked in June (average 93±69 days, p<0.001). On
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1 Urology, University of Montreal Hospital Center, Montreal, QC, MVA, patients booked in June had significantly more chance of having
Canada; Urology, University of Sherbrooke Hospital Center, Montreal, an increase in CAPRA score [(hazard ratio [HR] 1.64; 95% confidence
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QC, Canada; Urology, McGill University Health Center, Montreal, QC, interval [CI] 1.02–2.63; p=0.04) and in CAPRA risk group (HR 1.82; 95%
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Canada CI 1.04–3.19) after surgery compared to patients booked in other months.
Introduction: Compared to the other seasons of the year, most Canadian Moreover, Cohort analysis showed fair correlation between CAPRA-score
hospitals face significant reductions (20–50%) in operative room access difference and time between booking and RARP (r=-0.062; p=0.044).
during summer months due to nursing shortages, leading to increased Conclusions: Our cohort results demonstrate that conventional RARP wait
surgical delays. Hence, we sought to assess the impact of this extra wait times are significantly and consistently prolonged during summer months,
time to undergo robotic-assisted radical prostatectomy (RARP) on the with worse post-RARP oncological outcomes in terms of CAPRA score,
oncological outcomes of localized prostate cancer. which is associated with a higher risk of BCR. Further multispecialty and
Methods: We conducted a retrospective review of a prospectively main- large-scale national studies are required to address these delays in other
tained RARP database in two high-volume academic centers between oncological populations. Furthermore, other compensatory mechanisms
2010 and 2019. Wait time was defined as the interval between surgical to sustain consistent yearly operative output should be considered.
booking and RARP. Assessed outcomes included impact on the difference
between post-biopsy USCF-CAPRA and post-surgical CAPRA-S scores,
biochemical recurrence (BCR) rates, and Gleason score upgrade on surgi-
cal specimen. Multivariable analysis (MVA) with regression models was
used to evaluate the effect of wait times.

CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S103