Analysis Of The Efficacy About Endocrine Therapy Combined With Transurethral Resection Of The Prostate In The Treatment Of Advanced Prostate Cancer With Bladder Outlet Obstruction

Objective:To analyze the efficacy and prognosis of endocrine therapy combined with palliative transurethral resection of the prostate(pTURP)in the treatment of advanced prostate cancer with bladder outlet obstruction.Methods:A retrospective study from December 2009 to June 2015 in our hospital 40 cases of diagnosed advanced prostate cancer cases,including 17cases of locally advanced,23 cases of metastatic prostate cancer.Twenty-five patients were diagnosed with endocrine therapy combined with pTURP,who were set as the study group.Fifteen patients underwent endocrine therapy after definite diagnosis,set as the control group.The data of patients in hospital and regular followup were collected,and the data of two groups before treatment were compared.The clinical data after treatment of the study group were compared with before and control group,including the maximum urinary flow rate,IPSS score,prostate volume,prostate-specific antigen and median no progress time.Specific treatment of the study group:pTURP was done under spinal anesthesia with simultaneous castration.Some patients underwent surcigal castration(both orchidectomy),and eat bicalutamide 50mg/d.An-others take drug castration(3.75mg leuprolide for injection every 28 days)with bicalutamide.SPSS 17.0 software was used for statistical analysis.The meas-urement dates were expressed as mean±standard deviation and the median(four percentile interval).The samples were analyzed by t-test and variance or the rank-sum test;Count data expressed as a percentage,using the chi-square test and Fisher exact test.Variable grade data use the Wilcoxon rank sum test.The median no progress time were analyzed byKaplan-Meier analysis,which of the two groups were compared with Log Rank test;If Probability<0.05,which means that difference was statistically significant.Results:Ⅰ.The datas of two groups of patients before treatment are compared about age,prostate volume,prostate specific antigen,Gleason score,the proportion of metastatic prostate cancer,which are the indicators of the risk of prostate cancer.The two groups of patients with no difference,having comparability.Ⅱ.The dates after treatment of study group compared with before:prostate specific antigen,IPSS score and prostate volume decreased,the maximum flow rate improved.Study group is better than contol group when 1st and 3rd month after treatment.Ⅲ.The median no progress time in the study group was 30 months,and the control group 24 months.After Log Rank test,there was no significant difference between the two groups(x~2=1.382,P>0.05).Conclusions:Endocrine therapy combined with pTURP can be effective in the treatment of advanced prostate cancer with bladder outlet obstruction.Progression free rate curve of the two groups have no difference;Endocrine therapy combined with pTURP is safe and effective,which provides a basis for clinical application.