TY - JOUR
T1 - Does Transurethral Resection of Prostate (TURP) Affect Outcome in Patients Who Subsequently Develop Prostate Cancer?
AU - D'Ambrosio, David J.
AU - Ruth, Karen
AU - Horwitz, Eric M.
AU - Chen, David Y.T.
AU - Pollack, Alan
AU - Buyyounouski, Mark K.
PY - 2008/5
Y1 - 2008/5
N2 - Objectives: Pretreatment prostate specific antigen (PSA) is a strong predictor of prostate cancer outcome after radiotherapy and is a key parameter in pretreatment risk assessment. Because PSA is secreted from both benign and malignant tissue, a prior transurethral resection of prostate (TURP) may lower pretreatment PSA levels out of proportion to the extent of cancer. The purpose of this study was to determine whether a history of TURP is associated with increased biochemical failure (BF) after definitive radiotherapy for prostate cancer. Methods: From April 1989 to October 2001, 1135 men with low to intermediate risk T1c-2NX/0M0 (2002 AJCC) prostate cancer with a pretreatment PSA less than 20 ng/mL received three-dimensional conformal radiotherapy (median dose, 76 Gy) without androgen deprivation. The median pretreatment PSA was 7.4 ng/mL (range, 0.4 to 19.9). There were 126 men with a prior history of TURP. The Cox proportional hazards model was used for univariate and multivariate analyses for BF (nadir + 2 ng/mL definition). Results: On multivariable analysis, Gleason score (GS), PSA, and T-stage were significant predictors of BF in a model containing TURP and dose. A history of TURP was not a significant independent predictor of BF on subgroup analysis. There was a trend toward significance for the subgroup of GS less than 7 (P = 0.12). Conclusions: A history of prior TURP does not affect outcome after RT for prostate cancer in low to intermediate risk patients.
AB - Objectives: Pretreatment prostate specific antigen (PSA) is a strong predictor of prostate cancer outcome after radiotherapy and is a key parameter in pretreatment risk assessment. Because PSA is secreted from both benign and malignant tissue, a prior transurethral resection of prostate (TURP) may lower pretreatment PSA levels out of proportion to the extent of cancer. The purpose of this study was to determine whether a history of TURP is associated with increased biochemical failure (BF) after definitive radiotherapy for prostate cancer. Methods: From April 1989 to October 2001, 1135 men with low to intermediate risk T1c-2NX/0M0 (2002 AJCC) prostate cancer with a pretreatment PSA less than 20 ng/mL received three-dimensional conformal radiotherapy (median dose, 76 Gy) without androgen deprivation. The median pretreatment PSA was 7.4 ng/mL (range, 0.4 to 19.9). There were 126 men with a prior history of TURP. The Cox proportional hazards model was used for univariate and multivariate analyses for BF (nadir + 2 ng/mL definition). Results: On multivariable analysis, Gleason score (GS), PSA, and T-stage were significant predictors of BF in a model containing TURP and dose. A history of TURP was not a significant independent predictor of BF on subgroup analysis. There was a trend toward significance for the subgroup of GS less than 7 (P = 0.12). Conclusions: A history of prior TURP does not affect outcome after RT for prostate cancer in low to intermediate risk patients.
KW - Adenocarcinoma/blood
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Humans
KW - Male
KW - Middle Aged
KW - Prostate-Specific Antigen/blood
KW - Prostatic Neoplasms/blood
KW - Transurethral Resection of Prostate
KW - Treatment Failure
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=42749090644&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000255992000053&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.urology.2007.09.049
DO - 10.1016/j.urology.2007.09.049
M3 - Article
C2 - 18279939
SN - 0090-4295
VL - 71
SP - 938
EP - 941
JO - Urology
JF - Urology
IS - 5
ER -