Adverse effect of transurethral resection on disease-free survival in locally advanced prostatic cancer treated with irradiation.

Abstract

The purpose of this study was to analyze the impact of transurethral resection of the prostate on prognosis in patients with localized prostate cancer who received definitive external beam radiotherapy. Out of the 431 patients treated diagnosis was established by needle biopsy in 198 and by transurethral resection of the prostate in 233 cases. Disease-free survival and relative survival as a function of transurethral resection of the prostate and needle biopsy were calculated for all stages and within each tumor stage and grade. An adverse effect of transurethral resection of the prostate on disease-free survival was observed only in patients with T3 T4 tumors of intermediate and poor differentiation (p < 0.05). The incidence of local recurrence and distant metastases as well as the distribution of pretreatment prostate specific antigen-levels was not significantly different between the transurethral resection of the prostate and needle biopsy groups. We conclude that transurethral resection of the prostate has an adverse effect on disease-free survival in a selected group of patients and discuss the implications of this finding.