BACKGROUND: Biopsy progression on @entity3457 ( @entity3457 ) for @entity263 ( @entity263 ) often reflects failure of the initial biopsy to detect @entity5 present at enrollment. The risks for delayed treatment among @entity1 who progress on @entity3457 are not well defined. OBJECTIVE: To report outcomes for @entity1 who underwent surgery after @entity3457 compared to @entity1 who underwent immediate surgery and the influence of selection bias on this outcome. DESIGN, SETTING, AND @entity1 : @entity3457 -eligible (ASE) @entity1 who underwent radical prostatectomy (RP) after a median of 20 mo of @entity3457 were compared to ASE @entity1 who underwent RP within 6 mo of diagnosis. A subset of @entity1 on @entity3457 who underwent RP after upgrade to Gleason 3+4 was compared to matched controls with similar pretreatment biopsy features who underwent immediate RP. OUTCOME MEASUREMENT AND STATISTICAL ANALYSIS: Rates of adverse pathology (upstaging, positive surgical margin, or Gleason upgrading) were examined. Logistic regression was used to determine associations between treatment subgroup and adverse pathology. RESULTS AND LIMITATIONS: Of 157 ASE @entity1 who underwent delayed RP after @entity3457 , 54 were upgraded to Gleason 3+4 before surgery. ASE @entity1 who underwent immediate RP had lower probability of adverse pathology than ASE @entity1 who underwent delayed RP (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.21-0.55). The rate of adverse pathology did not differ between immediate and delayed RP @entity1 matched for pretreatment characteristics (HR 0.79, 95% CI 0.27-2.28). The observational design of this study is its main limitation. CONCLUSIONS: When compared to @entity1 with similar pretreatment biopsy features, those who underwent delayed RP were not at higher risk of adverse pathology. @entity1 SUMMARY: The oncologic safety of delayed treatment when indicated for @entity1 enrolled in @entity3457 for @entity263 is important. We found that @entity1 who underwent delayed surgery had similar outcomes to @entity1 who underwent immediate prostatectomy.

Immediate versus delayed radical prostatectomy: updated outcomes following @entity3457 of XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1 :: ('9606', 'Species') :: ['patients', 'PARTICIPANTS', 'PATIENT', 'men'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer', 'PCa'] @entity3457 :: ('OMIM:612348', 'Disease') :: ['active surveillance', 'AS']
@entity263 :: (MESH:D011471,Disease) :: ['prostate cancer']
