Subtotal transurethral prostatectomy in the treatment of patients with prostatic cancer

Abstract

The results are given of subtotal transurethral resection (subtotal TUR) in 21 patients with prostatic cancer (PC) operated in 19982004. The patients had contraindications to radical treatment. The aim of the surgical intervention was maximal possible removal of the prostatic tissue to the prostatic capsule that improves results of adjuvant hormonal and radiotherapy. Postoperative follow-up lasted from 6 months to 6 years. The control groups consisted of 20 patients subjected to palliative prostatic TUR and 24 PC patients given only hormonal or radiotherapy. Subtotal transurethral prostatectomy and TUR of the prostate were successfully made in all the patients. The number of postoperative complications and reoperations was less in patients after subtotal transurethral prostatectomy than in those after palliative TUR. The treatment reduced blood PSA levels in all the groups but the progress of this reduction depended on the treatment method. The group after subtotal transurethral prostatectomy achieved maximal PSA lowering after 2 months after surgery. The follow-up registered distant metastases in 19.04% patients of the study group and 20 and 29.4% in the control groups. One-year survival was 80.95, 80, 83.3%, respectively; 3-year survival was 80, 45.5 and 77.8%, respectively. Thus, combined treatment of prostatic cancer (subtotal transurethral prostatectomy and maximal androgenic blockade) rapidly corrects urination without deterioration of survival parameters compared to hormonal therapy alone.