Incidental carcinoma of the prostate: treatment selection by second-look TURP

Twenty consecutive patients, aged under 70 years, with an incidentally diagnosed (TONXMO) carcinoma of the prostate were studied to determine the value of a repeat (second-look) TURP in assessing the accuracy of the estimates of tumour grade and volume following a first resection and in selecting patients for deferred or definitive treatment. In 8 of the 20 cases no tumour was present in the second specimen and in three cases the quantities were insignificant. All patients were treated expectantly and none has developed disease progression. Appreciable residual tumour was still present in nine patients, four of whom have developed local progression despite treatment (radiotherapy or stilboestrol). It is concluded that a second-look TURP adds to the accuracy of the definition of the T-category and as such is a valuable adjunct in determining appropriate therapy in such patients.