EFFECTS OF PRETREATMENT TRANSURETHRAL RESECTION ON SURVIVAL IN PROSTATIC-CARCINOMA

The survival of 117 patients with carcinoma of the prostate treated wi th radiation at SUNY-Health Science Center at Brooklyn and Kings Count y Hospital Center was analyzed according to their pretreatment method of diagnosis. Sixty-four patients (54.7%) underwent a transurethral re section of the prostate (TURP) for obstructive symptoms prior to defin itive therapy, while 53 patients (45.3%) were diagnosed with needle bi opsy. The overall 5-year survival rate was 46% in the needle biopsy gr oup and 38% in the TURP group. Black and white patients with high Glea son scores (7 to 10) and black patients with low-grade tumors who unde rwent TURP had an adverse 5-year survival rate compared with those pat ients diagnosed by needle biopsy. The 5-year survival rate of patients with high Gleason scores comparing needle and TURP was 37% versus 16% . The 5-year survival rate of black patients with low-grade tumors com paring needle biopsy versus TURP was 50% and 22%, respectively, althou gh not statistically significant because of the small sample size. Whe n evaluated by stage, there was no difference in survival rates of TUR P versus needle biopsy. Black patients who underwent TURP had a 28% 5- year survival rate compared with a 44% 5-year survival rate in white T URP patients. This analysis reveals that black and white patients with high-grade tumors and black patients, even with low-grade tumors, may have a lower survival rate if they undergo TURP prior to radiation, b ut this may be due to higher stage and larger volume disease in these patients.