{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:30:13Z","timestamp":1787243413007,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: In high-risk prostate cancer, the optimal timing of radical prostatectomy after diagnostic biopsy remains a clinically important issue. A real-world delay between diagnosis and radical treatment frequently occurs, raising concerns about potential disease progression in high-risk patients. Methods: We conducted a single-center retrospective study including patients with high-risk localized and locally advanced prostate cancer who underwent radical prostatectomy from January 2016 to January 2026. Patients were stratified according to biopsy-to-radical prostatectomy interval into two groups: &lt;90 days or \u226590 days. Adverse pathological outcomes were defined as extraprostatic extension, seminal vesicle involvement, positive surgical margins and lymph-node involvement. Univariable comparisons and multivariable logistic regression analyses were performed to identify independent predictors of adverse pathology. Results: A total of 158 patients with high-risk prostate cancer were included, of whom 67 (42.4%) underwent open- or laparoscopic radical prostatectomy within 90 days after biopsy and 91 (57.6%) after \u226590 days. On univariable analysis, the rates of extraprostatic extension were 59.7% vs. 63.7% in the &lt;90-day and \u226590-day groups (p = 0.606), seminal vesicle involvement was observed in 22.4% vs. 24.2% (p = 0.627), positive surgical margins in 35.8% vs. 39.6% (p = 0.632), and lymph node involvement in 6% vs. 5.5% (p = 0.999). In multivariable logistic regression, a biopsy-to-radical prostatectomy interval \u226590 days was not independently associated with extraprostatic extension (OR 1.38, 95% CI 0.68\u20132.77, p = 0.371), seminal vesicle involvement (OR 1.43, 95% CI 0.63\u20133.27, p = 0.391) or positive surgical margins (OR 1.31, 95% CI 0.66\u20132.62, p = 0.443). The number of positive biopsy cores independently predicted extraprostatic extension (OR 1.17, 95% CI 1.04\u20131.32, p = 0.008), while higher PSA independently predicted seminal vesicle involvement (OR 1.05, 95% CI 1.01\u20131.10, p = 0.025) and positive surgical margins (OR 1.05, 95% CI 1.00\u20131.10, p = 0.027). Conclusions: In this real-world cohort of patients with high-risk prostate cancer undergoing radical prostatectomy, no statistically significant independent association was detected between a biopsy-to-radical prostatectomy interval \u226590 days and extraprostatic extension, seminal vesicle involvement, or positive surgical margins. However, the confidence intervals remained compatible with potentially clinically meaningful differences, and residual confounding from clinician-driven prioritisation and unmeasured preoperative factors cannot be excluded. Therefore, these findings should not be interpreted as demonstrating equivalence or the safety of delaying surgery.<\/jats:p>","DOI":"10.3390\/diagnostics16162662","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:05:19Z","timestamp":1787241919000},"page":"2662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Biopsy-to-Radical Prostatectomy Interval on Adverse Pathological Outcomes in High-Risk Localized and Locally Advanced Prostate Cancer"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8009-3482","authenticated-orcid":false,"given":"Lorand Tibor","family":"Reman","sequence":"first","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliv\u00e9r \u00c1rp\u00e1d","family":"Vida","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103lin","family":"Chibelean","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4279-673X","authenticated-orcid":false,"given":"Daniel","family":"Porav-Hodade","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian Todea","family":"Moga","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica Maria","family":"Ghirca","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4778-380X","authenticated-orcid":false,"given":"Raul-Dumitru","family":"Gherasim","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rares-Florin","family":"Vascul","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya-Brigitta","family":"Katona","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, County Emergency Clinic Hospital of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5693-8483","authenticated-orcid":false,"given":"Szabolcs","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edva Anna","family":"Frunda","sequence":"additional","affiliation":[{"name":"Institution Organizing University Doctoral Studies (I.O.S.U.D.), George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya Katalin Ilona","family":"Martha","sequence":"additional","affiliation":[{"name":"Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Urology, Mures Clinic County Hospital, Piata Bernady Gyorgy, Nr. 6, 540072 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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