Radical Transurethral Resection for Prostate Cancer Might Affect the Disputes about Prostate-Specific Antigen Screening: Suggestions Obtained from Radical Transurethral Surgery
- Masaru Morita
- Takeshi Matsuura
To find an answer to the argument whether prostate specific antigen (PSA)-based mass screening would be beneficial or inexpedient for patients, we analyzed our result of 150 radical transurethral resection of prostate cancer in 126 patients with stage T1c disease. Preoperative PSA ranged from 2.00 to 66.3 ng/mL (median, 5.65). The median follow-up periods of the 115 patients except for 11 dropouts were 63.8 months. PSA recurrence developed in nine patients (7.8%). The other 106 patients have stable PSA as follows: PSA <= 0.01, 42 patients<= 0.02, 19 patients; <= 0.03, 10 patients; <= 0.04, 6 patients; <= 0.1, 10 patients, <= 0.2, 7 patients; <=0.9, 12 patients. PSA nonrecurrence rates according to D’Amico’s risk group were 100% for the low-risk group, 93% for the intermediate-risk group and 79% for the high-risk group. The most frequent complication was bladder neck contracture (developed in 33.0% of patients) and easily treated by optical urethrotomy. Postoperative urinary incontinence was temporary and disappeared within 3 months. Erectile function was preserved in 51.3%. We obtained satisfactory oncological and functional outcomes in patients with T1c prostate cancer by RTUR-PCa. Proper indication of the procedure with much longer follow-up might affect the dispute that PSA mass screening might tend to be overdiagnosis and overtreatment as long as PSA screening was properly indicated.
- Lexie GreyEditorial Assistant