NEGATIVE REPEAT TRANSURETHRAL RESECTION OF PROSTATE FAILS TO IDENTIFYPATIENTS WITH STAGE-A1 PROSTATIC-CARCINOMA AT LOWER RISK OF PROGRESSION - A LONG-TERM STUDY

Stage Al (low-grade and low-volume) adenocarcinoma is associated with a low likelihood of progression. Repeat transurethral resection has be en used to identify patients at increased risk (residual cancer noted) as well as those at low risk of progression (no residual cancer noted ). We recently evaluated the ability of this technique to define a low -risk patient population. We reviewed the records of 24 patients who u nderwent repeat transurethral resection after they were identified as having Stage Al prostatic cancer on initial resection (Gleason score < 5, tumor volume comprising < 5% of the resection specimen). Despite n o evidence of residual carcinoma on repeat resection, 3 patients (13%) progressed at a mean follow-up of seven years (2 locally, 1 locally a nd distantly). We conclude that repeat resection does not effectively evaluate the risk of progression and that other techniques including t ransrectal ultrasonography and serial prostate-specific antigen measur ements should be similarly evaluated.