PROLIFERATIVE RESPONSE OF HUMAN PROSTATE TUMOR XENOGRAFTS TO SURGICALTRAUMA AND THE TRANSURETHRAL RESECTION OF THE PROSTATE CONTROVERSY

Transurethral resection of the prostate (TURP) as an excisional proced ure involving multiple incisions into the prostate does not differenti ate between palpably benign prostate tissue and microscopic foci of we ll-differentiated adenocarcinoma. The impact of TURF on the progressio n of such 'latent' or 'incidental' tumours unique to the prostate glan d has been a focal point of a continuing controversy. In studies desig ned to develop preclinical evidence that would lend support to, or det ract from, either side of the TURF controversy, surgical trauma-induce d stimulation of in situ tumour growth was extended to include human p rostate tumour tissue PC-3, DU-145 and H-1579, albeit as xenografts in athymic nude males. A significant proliferative response of prostate rumours implanted directly in, adjacent to, or distant from, a freshly induced surgical wound, could be inhibited by a somatostatin analogue (Lanreotide) applied topically to the surgical site. This preclinical model supports TURF as a risk factor for biopsy or therapeutic surgic al intervention procedures in benign prostatic hypertrophy (BPH), a ri sk factor that increases with the stage of disease in undetected cance rs. It also suggests a potential clinical benefit that might be derive d by applying Lanreotide directly to the surgically traumatised genito urinary area by simple irrigation of the urethra and bladder during or shortly post TURP.