The dissemination of cancer by transurethral resection of locally advanced prostate cancer.

In 1973 a study was done on 443 patients treated with radiation therapy for cancer of the prostate. An actuarial analysis was done on survival comparing patients whose cancer was diagnosed by transurethral resection of the prostate to those diagnosed by needle biopsy. This analysis indicated a doubling of recurrence and of deaths of patients diagnosed by transurethral resection of the prostate. This effect of transurethral resection of the prostate was observed in patients with T3 and T4 cancer of intermediate, poor or unstated differentiation. It was not observed in those with well differentiated cancer. The effect was not caused by a difference in the extent of cancer or a distribution of histologic subtypes between the 2 diagnostic groups. Therefore, it appears that transurethral resection of the prostate causes dissemination on locally advanced prostatic cancer and clinical studies are suggested to avoid or minimize this effect.