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Abstract

Volume 22, Issue 2 (March 2020) 22, 217–221; 10.4103/aja.aja_54_19

Transurethral resection of the prostate is an independent risk factor for biochemical recurrence after radical prostatectomy for prostate cancer

Kun Jin1, Shi Qiu1,2, Xin-Yang Liao1, Xiao-Nan Zheng1, Xiang Tu1, Lian-Sha Tang1, Lu Yang1, Qiang Wei1

1 Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041, China
2 Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu 610041, China

Correspondence: Dr. Q Wei (weiqiang163163@163.com) or Dr. L Yang (wycleflue@163.com)

14-Jun-2019

Abstract

Biochemical recurrence (BCR) is important for measuring the oncological outcomes of patients who undergo radical prostatectomy (RP). Whether transurethral resection of the prostate (TURP) has negative postoperative effects on oncological outcomes remains controversial. The primary aim of our retrospective study was to determine whether a history of TURP could affect the postoperative BCR rate. We retrospectively reviewed patients with prostate cancer (PCa) who had undergone RP between January 2009 and October 2017. Clinical data on age, prostate volume, serum prostate-specific antigen levels (PSA), biopsy Gleason score (GS), metastasis stage (TNM), D'Amico classification, and American Society of Anesthesiologists (ASA) classification were collected. Statistical analyses including Cox proportional hazard models and sensitivity analyses which included propensity score matching, were performed, and the inverse-probability-of-treatment-weighted estimator and standardized mortality ratio-weighted estimator were determined. We included 1083 patients, of which 118 had a history of TURP. Before matching, the non-TURP group differed from the TURP group with respect to GS (P= 0.047), prostate volume (mean: 45.19 vs 36.00 ml, P < 0.001), and PSA level (mean: 29.41 vs 15.11 ng ml−1, P= 0.001). After adjusting for age, PSA level, T stage, N stage, M stage, and GS, the TURP group showed higher risk of BCR (hazard ratio [HR]: 2.27, 95% confidence interval [CI]: 1.13–3.94, P= 0.004). After matching (ratio 1:4), patients who underwent TURP were still more likely to develop BCR according to the adjusted propensity score (HR: 2.00, 95% CI: 1.05–3.79, P= 0.034). Among patients with PCa, those with a history of TURP were more likely to develop BCR after RP.

Keywords: biochemical recurrence; prostate cancer; radical prostatectomy; transurethral resection

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