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Impact of surgical wait times during summer months on the oncological outcomes following robotic-assisted radical prostatectomy: 10 years’ experience from a large Canadian academic center

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Abstract

Purpose

Most Canadian hospitals face significant reductions in operating room access during the summer. We sought to assess the impact of longer wait times on the oncological outcomes of localized prostate cancer patients following robotic-assisted radical prostatectomy (RARP).

Methods

We conducted a retrospective review of a prospectively maintained RARP database in two high-volume academic centers, between 2010 and 2019. Assessed outcomes included the difference between post-biopsy UCSF-CAPRA and post-surgical CAPRA-S scores, Gleason score upgrade and biochemical recurrence rates (BCR). Multivariable regression analyses (MVA) were used to evaluate the effect of wait times.

Results

A total of 1057 men were included for analysis. Consistent over a 10 year period, summer months had the lowest surgical volumes despite above average booking volumes. The lowest surgical volume occurred during the month of July (7.1 cases on average), which was 35% less than the cohort average. The longest average wait times occurred for patients booked in June (93 ± 69 days, p < 0.001). On MVA, patients booked in June had significantly more chance of having an increase in CAPRA score [HR (95% CI) 1.64 (1.02–2.63); p = 0.04] and in CAPRA risk group [HR (95% CI) 1.82 (1.04–3.19); p = 0.03]. Cohort analysis showed fair correlation between CAPRA-score difference and wait time (Pearson correlation: r =  − 0.062; p = 0.044).

Conclusion

Our cohort results demonstrate that conventional RARP wait times are significantly and consistently prolonged during summer months over the past 10 years, with worse post-RARP oncological outcomes in terms of CAPRA scores. Other compensatory mechanisms to sustain consistent yearly operative output should be considered.

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Funding

This study was supported by Urology division; University of Montreal and no external fund was obtained.

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Urology, Centre Hospitalier de L’université de Montréal (CHUM), Montreal, QC, Canada

    Ahmed S. Zakaria, Hanna Shahine, Franziska Stolzenbach, Pierre I. Karakiewicz & Kevin C. Zorn

  2. Department of Surgery, Division of Urology, Centre Hospitalier de L’université de Sherbrooke, Sherbrooke, QC, Canada

    Félix Couture

  3. Faculty of Medicine, McGill University, Montreal, QC, Canada

    David-Dan Nguyen

  4. Department of Surgery, Division of Urology, McGill University, Montreal, QC, Canada

    Côme Tholomier

  5. Department of Surgery, Division of Robotic Urology, Hôpital du Sacré Coeur de Montréal, Montreal, QC, Canada

    Malek Meskawi & Assaad El-Hakim

Authors
  1. Ahmed S. Zakaria
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  2. Félix Couture
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  3. David-Dan Nguyen
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  4. Côme Tholomier
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  8. Pierre I. Karakiewicz
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  9. Assaad El-Hakim
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  10. Kevin C. Zorn
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Contributions

ZAS: project development, data collection, data analysis and manuscript writing. CF: project development, data analysis and manuscript writing. NDD: project development, data analysis and manuscript writing. TC: project development and manuscript writing. SH: project development and manuscript writing. SF: project development and manuscript writing. MM: project development and manuscript writing. KP: project development and manuscript writing. EA: project development and manuscript writing. ZKC: project development, data collection, data analysis and manuscript writing.

Corresponding author

Correspondence to Kevin C. Zorn.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study (Retrospective), formal consent is not required.

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Zakaria, A.S., Couture, F., Nguyen, DD. et al. Impact of surgical wait times during summer months on the oncological outcomes following robotic-assisted radical prostatectomy: 10 years’ experience from a large Canadian academic center. World J Urol 39, 2913–2919 (2021). https://doi.org/10.1007/s00345-020-03496-2

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  • DOI: https://doi.org/10.1007/s00345-020-03496-2

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