The Therapeutic Effect Of TURP Plus Novel Endocrine Therapy On Patients In Their Terminal Stage Of CRPC With BOO

Objective: Recently,standard treatment for metastatic castration-resistant prostate cancer is novel endocrine therapy or chemotherapy.However,the treatment of CRPC patients with bladder outlet obstruction is limited.Therefore,we study the therapeutic effect of TURP plus new endocrine therapy(Abiraterone Acetate)on patients in terminal stage of CRPC with BOO.Methods: We retrospectively analyze the patients of Urology Department of Sheng Jing Hospital in their terminal stage of CRPC with BOO during 2017 to 2019.A total of 62 patients were divided into 2 groups by random assignment.The 31 patients who received the therapy of TURP plus AA are selected as experimental group.The 31 patients who received AA only are selected as control group.The operation time,the span of indwelling catheter,PSA,QOL IPSS,RU,Qmax,and complication are respectively recorded.The conditions of survival after12 months were followed.Results:In the experimental group,The age of 31 patients was 61.67±20.23,the volume of prostate was 61.67±20.23 ml.Before operation,PSA was 68.72±10.21ng/mL,IPSS was 24.31±4.15,QOL was 5.14±1.47,Qmax was 9.37±7.54ml/s,RU was 34.89±11.15 ml,all the stage of them was T4,the complications were not found in all the patients.Three month after operation,PSA was 14.13±17.41ng/ml,Qmax was 17.14±9.12,RU was 34.89±11.15 ml,IPSS was 11.13±5.21,QOL was 2.67±1.76.We use Wilcoxon test to compare the data and the difference is statistically significant.We did not find any complications after treatment.Three patients died 6 months,9 months and 11 month after treatment,while the rest survived 12 months after treatment.In the control group,the age of 31 patients was 77.45±20.23,the volume of prostate was 54.23±33.45 ml.Before treatment,PSA was 61.24±17.23ng/ml,IPSS was 22.13±9.25,QOL was 5.02±1.98,Qmax was 11.88±9.82ml/s,RU was 67.49±26.23 ml.3 month after treatment,PSA was 39.13±27.53ng/ml,Qmax was 11.88±9.82ml/s,RU was 67.49±26.23 ml,IPSS was 18.13±15.21,QOL was5.87±1.76.We use Wilcoxon test to compare the PSA and the difference isstatistically significant.But the difference of other data are not statistically significant Three patients died at 7,8 and 10 months,while the rest survived at 12 months.We use Wilcoxon test to campare the two group.Before treatment,there is no statistically significant differences of data between the experimental group and the control group.3 months after treatment,the PSA,IPSS,QOL and RU of the experimental are lower than the control group,Qmax is higher than the control group and the difference is statistically significant.The survival of the two groups was compared by the K-M curve,and the P value is calculated by log-rank,but the difference was not statistically significant.Conclusion: Compared with AA only,The therapeutic effect of TURP plus AA on the terminal stage of CRPC is efficacious.It can reduce PSA,IPSS,RU,QOL and increase Qmax,enhance the quality of life,which is worth spreading..Moreover,there isno significant difference in the effect on survival in a short time.