AUTHOR=Fang Kun , Song Pan , Zhang Jiahe , Yang Luchen , Liu Peiwen , Lu Ni , Dong Qiang 

TITLE=The Impact of Palliative Transurethral Resection of the Prostate on the Prognosis of Patients With Bladder Outlet Obstruction and Metastatic Prostate Cancer: A Population-Matched Study

JOURNAL=Frontiers in Surgery

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.726534

DOI=10.3389/fsurg.2021.726534

ISSN=2296-875X

ABSTRACT=<p><bold>Objective:</bold> This study aimed to evaluate the survival outcomes of patients with bladder outlet obstruction (BOO) and metastatic prostate cancer (mPCa) after having a palliative transurethral resection of the prostate (pTURP) surgery.</p><p><bold>Methods:</bold> We identified patients with mPCa between 2004 and 2016 in the Surveillance, Epidemiology, and End Results (SEER) database. Patients who received pTURP and non-surgical therapy were identified. A propensity-score matching was introduced to balance the covariate. Kaplan–Meier analysis and COX regression were conducted to evaluate the overall survival (OS) and cancer-specific survival (CSS) outcomes.</p><p><bold>Results:</bold> A total of 36,003 patients were identified; 2,823 of them were in the pTURP group and 33,180 were in the non-surgical group. The survival curves of the overall cohort showed that the pTURP group was associated with worse outcomes in both OS (HR: 1.12, 95% CI: 1.07–1.18, <italic>p</italic> &lt; 0.001) and CSS (HR: 1.08, 95% CI: 1.02–1.15, <italic>p</italic> = 0.004) compared with the non-surgical group. The mean survival time in the overall cohort of the pTURP group was shorter than the non-surgical group in both OS [35.13 ± 1.53 vs. 40.44 ± 0.59 months] and CSS [48.8 ± 1.27 vs. 55.92 ± 0.43 months]. In the matched cohort, the pTURP group had significantly lower survival curves for both OS (HR: 1.25, 95% CI: 1.16–1.35, <italic>p</italic> &lt; 0.001) and CSS (HR: 1.23, 95% CI: 1.12–1.35, <italic>p</italic> &lt; 0.001) than the non-surgical group. pTURP significantly reduced the survival months of the patients (36.49 ± 0.94 vs. 45.52 ± 1.23 months in OS and 50.1 ± 1.49 vs. 61.28 ± 1.74 months in CSS). In the multivariate COX analysis, pTURP increased the risk of overall mortality (HR: 1.19, 95% CI: 1.09–1.31, <italic>p</italic> &lt; 0.001) and cancer-specific mortality CSS (HR: 1.23, 95% CI: 1.14–1.33, <italic>p</italic> &lt; 0.001) compared with the non-surgical group.</p><p><bold>Conclusions:</bold> For mPCa patients with BOO, pTURP could reduce OS and CSS while relieving the obstruction.</p>