Role of transurethral resection in dissemination of cancer of prostate.

Recent studies have suggested an adverse impact on disease progression and survival in patients with prostatic cancer who undergo transurethral resection (TURP). Four hundred fifteen patients with prostatic carcinoma were reported to a Tumor Registry from 1965 to 1971. Of these, 184 charts had sufficient follow-up data to assess the impact of TURP in each stage of prostatic cancer. In Stage A the five-year survival difference between the TURP group (87.5%) and the open prostatectomy group (88%) was not significant (P = 0.54). In Stage B the five-year survival difference between the TURP group (38.7%) and the needle biopsy group (68%) was significant (P = 0.02). In Stages C and D there was no significant difference in survival between the TURP group and the needle biopsy group (P = 0.44 and P = 0.2, respectively). Our data reinforce the importance of diagnosing Stage B prostatic cancer preoperatively when curative treatment modalities may be utilized and TURP avoided. Finally, in advanced stages TURP may be efficacious in relieving prostatic obstruction while not adversely influencing survival.