OPERATIVE COURSE OF TRANSURETHRAL RESECTION OF THE PROSTATE AND PROGRESSION OF PROSTATE-CANCER

Surgery has the potential to disseminate cancer cells, and we therefor e hypothesized that extensive transurethral resections of the prostate (TURP) would be followed by a worse prognosis than minor ones. For th is purpose, the association between the extent of surgery, disease pro gression, and mortality was studied in 138 patients with prostatic can cer who had undergone TURP. The results show that a large bleed (great er than or equal to 275 ml) indicated a slightly increased relative ri sk of general progression of the cancer (relative risk (RR) = 1.9, 95% confidence interval (CI)= 0.9-4.1) and death (RR = 1.5, CI = 0.6-3.3) . Other parameters of extensive surgery, such as the operating time an d fluid absorption, were not associated with increased risk. Patients with a medical disease, however, such as hypertension and congestive h eart failure, had a significantly higher relative risk of general prog ression (RR = 2.7, CI = 1.2-6.1) and death from prostatic cancer (RR = 4.6, CI = 2.0-10.7) in addition to an increased relative risk of deat h from other causes (RR = 3.7, CI = 1.3-10.5). We conclude that concur rent medical disease, but not an extensive TURP, worsened the prognosi s of patients with prostatic cancer who underwent TURP.