Does time interval between prostate biopsy and surgery affect outcomes of radical prostatectomy? A systematic review and meta-analysis

This study aimed at exploring whether the time interval (TI) between prostate biopsy and surgery affect the outcomes of radical prostatectomy (RP). A comprehensive search of the PubMed, Embase, and Cochrane Library databases was conducted to identify all eligible studies. After quality assessment and date extraction, a systematic review and meta-analysis was performed. A total of 9 studies with 8579 patients were included in our meta-analysis. Pooled data showed no significant differences between groups of TI ≤ 2 weeks and > 2 weeks in operative time, estimated blood loss, transfusion rate, bilateral nerve preservation, positively surgical margin, and complications. For comparison between TI ≤ 4 and > 4 weeks, shorter TI would be associated with significantly less estimated blood loss (p = 0.045) and lower rate of bilateral nerve preservation (p = 0.002). In addition, for TI ≤ 6 versus > 6 weeks, significantly less bilateral nerve preservation (p = 0.025) and more positive surgical margin (p = 0.020) could be found in the earlier surgery group. Sensitivity analysis indicated that TI had no impact on any outcomes of robot-assisted laparoscopic radical prostatectomy (RALP). As shorter TI was associated with lower rate of bilateral nerve preservation and higher rate of positive surgical margin, it would be better to perform RP with a TI of 4 or 6 weeks after biopsy. While for RALP, shorter TI did not have any impact on outcomes of RALP, It is feasible and safe to perform RALP within 2, 4, or 6 weeks.