Prostate cancer (PCa) is the second most frequently diagnosed cancer in men worldwide,
accounting for 15% of all male cancers. In 2015, there were 220,800 estimated new cases of
prostate cancer and 27,540 deaths by PCa, making this disease the second leading cause of
cancer-related death for North American men.
Men with PCa may develop lower urinary tract symptoms (LUTS) when prostate tumors invade or
compress the prostatic urethra, the bladder or the neurovascular bundles, or when the
prostate is enlarged. It has been estimated that over 40% of men with PCa experience moderate
or severe LUTS. LUTS can impact profoundly on a man's quality of life (QoL); an effect that
increases with increasing LUTS severity.
Transurethral resection of prostate (TURP) can offer immediate relief of the obstruction in
patients with benign prostatic hyperplasia (BPH). In contrast, palliative TURP (p-TURP) (the
so-called "channel" TURP), is transurethral resection of prostate tissue in a patient with
metastatic or locally advanced and/or previously treated PCa to alleviate obstructive voiding
symptoms.
Al¬though TURP is commonly performed to relieve bladder outlet ob¬struction (BOO) symptoms in
patients with BPH, little known about the outcome of palliative transurethral plasma kinetic
resection of prostate (p-TUPKRP) in patients with ad-vanced PCa.
Gonadotropin-releasing hormone (GnRH) agonists as androgen deprivation therapy (ADT) are the
standard treatment for many patients with PCa, particularly those with advanced or metastatic
disease. The impact of ADT on tumor control and achieving the reduction in prostate specific
antigen (PSA) is well established. But there is less information available on the effects on
LUTSs in men with PCa. Some short-term studies of ADT with the GnRH antagonist or with ADT in
the neoadjuvant setting have demonstrated reductions in LUTSs, measured by the International
Prostate Symptom Score (IPSS). There are few published data on the longer-term effects of ADT
on LUTSs, apart from an earlier interim analysis of data from the current study.
In this study, p-TUPKRP combined with ADT will perform for 50 patients with advanced PCa
complicated with severe LUTS. As a control, other 50 advanced PCa patients with same symptoms
will be treated with ADT only. Some clinical data, including PSA, IPSS, QoL, Urinary flow
rate (UFR), ECOG Score, Overall survival (OS), progression-free survival (PFS), will be
analyzed. It is expected to explore the efficacy and safety of the combination therapy to
advanced PCa with severe LUTS.
Phase:
N/A
Details
Lead Sponsor:
The Third Xiangya Hospital of Central South University