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Prostate Cancer Diagnosis by Transurethral Resection of the Prostate Is Associated with Compromised Oncologic
Abdullah Al-Khanaty1,2, Marlon Perera1,2,3, Brendan Yanada4
1Department of Surgery, Austin Health, University of Melbourne, Melbourne, VIC 3084, Australia.
Cancers
|February 27, 2026
Summary
Incidental prostate cancer diagnosis via transurethral resection of the prostate (TURP) is linked to worse overall survival compared to diagnosis via prostate biopsy. This finding is critical as TURP is increasingly used.
Area of Science:
- Urology
- Oncology
- Public Health
Background:
- Transurethral resection of the prostate (TURP) incidentally diagnoses prostate cancer in 2-10% of cases.
- The comparative outcomes of prostate cancer diagnosed via TURP versus traditional methods are not well-defined.
Purpose of the Study:
- To compare post-prostatectomy outcomes between patients diagnosed with prostate cancer via TURP and those diagnosed via prostate biopsy.
- To analyze overall survival and prostate cancer-specific mortality based on diagnostic pathway.
Main Methods:
- Utilized data from the Victorian Prostate Cancer Outcomes Registry (PCOR-Vic) for patients undergoing prostatectomy (2008-2020).
- Included 12,022 patients diagnosed by needle biopsy or TURP.
- Employed Kaplan-Meier plots, log-rank tests, and multivariable Cox/Fine and Gray regression models for survival analysis.
Main Results:
- 159 patients (1.3%) were diagnosed via TURP.
- TURP diagnosis was associated with significantly poorer 5-year overall survival (91.2% vs. 96.7%, p=0.001).
- Multivariable analysis showed a hazard ratio of 2.33 for overall survival in TURP vs. biopsy patients.
Conclusions:
- Prostate cancer diagnosis through TURP correlates with inferior overall survival compared to diagnosis via prostate biopsy.
- These results highlight clinical implications, especially with the rise of procedures like photoselective vaporization of the prostate, which yield limited tissue for pathological evaluation.
