Document Detail


Palliative transurethral resection of the prostate: functional outcome and impact on survival.
MedLine Citation:
PMID:  17034496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the long-term functional and oncological outcome in a consecutive series of patients undergoing palliative transurethral resection of the prostate (pTURP). PATIENTS AND METHODS: We retrospectively assessed all patients who had a pTURP between 1992 and 2004 at our institution. Patients with incidental prostate cancer (pT1a/pT1b) were excluded. In all, 89 patients (mean age 75.9 years, sd 0.9, at diagnosis) entered the study. RESULTS: The median (range) prostate-specific antigen level at diagnosis was 25.7 (0.7-5000) ng/mL and the mean Gleason score was 7. The mean (sd, range) interval between the diagnosis of prostate cancer and pTURP was 1.5 (0.3, 0.5-10.9) years. The indications for pTURP were refractory urinary retention in 30%, severe bladder outlet obstruction with a postvoid residual urine volume of > 100 mL in 43%, and bladder stones, haematuria and hydronephrosis in 9% each. The mean (sd, range) follow-up after pTURP was 2.6 (0.2, 0.1-7.3) years. The peri-operative mortality (<30 days) was 2%, and 22 patients (25%) died during the follow-up. As estimated by Kaplan-Meier analysis, the 1-, 2- and 5-year survival rates were 83%, 70% and 61%, respectively. Patients with prostate cancer in the pTURP specimen had a shorter 3-year survival (52%) than those with a negative histology (89%, P = 0.03). At the last follow-up, 79% of men voided spontaneously and were continent. A repeat pTURP was necessary in 25% of patients, 11% required permanent catheterization and 10% were incontinent. CONCLUSION: Despite greater peri-operative mortality and morbidity than conventional TURP, pTURP is a fairly safe and effective procedure. Although a potential negative impact of pTURP on survival cannot be excluded, the estimated 5-year survival of 61% in this series seems to justify this intervention.
Authors:
Martin Marszalek; Anton Ponholzer; Michael Rauchenwald; Stephan Madersbacher
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Publication Detail:
Type:  Journal Article     Date:  2006-10-11
Journal Detail:
Title:  BJU international     Volume:  99     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-17     Completed Date:  2007-02-12     Revised Date:  2007-05-17    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  56-9     Citation Subset:  IM    
Affiliation:
Department of Urology and Andrology, Donauspital, Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Male
Middle Aged
Palliative Care / methods*
Prostate-Specific Antigen / blood
Prostatic Neoplasms / mortality,  pathology,  surgery*
Retrospective Studies
Survival Rate
Transurethral Resection of Prostate* / mortality
Treatment Outcome
Chemical
Reg. No./Substance:
EC 3.4.21.77/Prostate-Specific Antigen
Comments/Corrections
Comment In:
BJU Int. 2007 Apr;99(4):942   [PMID:  17378857 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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