Does Transurethral Resection of Prostate (TURP) Affect Outcome in Patients Who Subsequently Develop Prostate Cancer?

David J. D'Ambrosio, Karen Ruth, Eric M. Horwitz, David Y T Chen, Alan Pollack, Mark K. Buyyounouski

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)938-941
Number of pages4
JournalUrology
Volume71
Issue number5
DOIs
StatePublished - May 1 2008
Externally publishedYes

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Transurethral Resection of Prostate
Prostate-Specific Antigen
Prostatic Neoplasms
Neoplasm Grading
Radiotherapy
Conformal Radiotherapy
Proportional Hazards Models
Androgens
Multivariate Analysis
Neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Does Transurethral Resection of Prostate (TURP) Affect Outcome in Patients Who Subsequently Develop Prostate Cancer? / D'Ambrosio, David J.; Ruth, Karen; Horwitz, Eric M.; Chen, David Y T; Pollack, Alan; Buyyounouski, Mark K.

In: Urology, Vol. 71, No. 5, 01.05.2008, p. 938-941.

Research output: Contribution to journalArticle

D'Ambrosio, David J. ; Ruth, Karen ; Horwitz, Eric M. ; Chen, David Y T ; Pollack, Alan ; Buyyounouski, Mark K. / Does Transurethral Resection of Prostate (TURP) Affect Outcome in Patients Who Subsequently Develop Prostate Cancer?. In: Urology. 2008 ; Vol. 71, No. 5. pp. 938-941.
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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.

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