Article Data

  • Views 792
  • Dowloads 154

Original Research

Open Access

Enhancing androgen ablation response in metastatic hormone-sensitive prostate cancer: the benefits of transurethral resection of the prostate

  • Yan Zhao1,2,†
  • Jie Liang2,†
  • Qian Wang2
  • Jing-Yi Cao2
  • Zhi-Xiang Yin1
  • Han-Yong Feng1
  • Yu-Hao Peng1
  • Nian-Xin Gai1
  • Chang-Song Pei1,*,

1Department of Urology, The First Affiliated Hospital of Soochow University, 215006 Suzhou, Jiangsu, China

2Department of Urology, Xuzhou Cancer Hospital, Affiliated Hospital of Jiangsu University, 221000 Xuzhou, Jiangsu, China

DOI: 10.22514/jomh.2023.056 Vol.19,Issue 7,July 2023 pp.39-44

Submitted: 25 November 2022 Accepted: 15 March 2023

Published: 30 July 2023

*Corresponding Author(s): Chang-Song Pei E-mail:

† These authors contributed equally.


Presently, there is limited data on the potential survival benefits of transurethral resection of the prostate (TURP) in patients with metastatic hormone-sensitive prostate cancer (mHSPCa). In this study, we aimed to assess the effects of TURP on the survival of mHSPCa patients. Of the 59 patients diagnosed with mHSPCa included, 28 received androgen deprivation therapy (ADT) alone, and the remaining received TURP plus ADT. Their time to biochemical progression (TBCP) and progression-free survival (PFS) were analyzed. Our results showed that for a median follow-up time of 15 (range, 3–40) months and 21 (range, 6–39) months for the ADT group and the TURP group, respectively, the TURP group exhibited significantly longer TBCP than the ADT group (p = 0.020). In addition, patients in the TURP group had numerically longer PFS, although the difference between the two groups was not significantly different (p = 0.110). Cox multivariate analysis indicated that longer TBCP was independently associated with TURP (p = 0.032) and lower Gleason scores (p = 0.001). Altogether this study showed that TURP could prolong TBCP and potentially improve the PFS of mHSPCa patients. However, further studies with a larger sample size are needed to confirm these findings.


Metastasis prostate cancer; Hormone sensitive; Transurethral resection of the prostate; Progression-free survival; Time to castration resistance

Cite and Share

Yan Zhao,Jie Liang,Qian Wang,Jing-Yi Cao,Zhi-Xiang Yin,Han-Yong Feng,Yu-Hao Peng,Nian-Xin Gai,Chang-Song Pei. Enhancing androgen ablation response in metastatic hormone-sensitive prostate cancer: the benefits of transurethral resection of the prostate. Journal of Men's Health. 2023. 19(7);39-44.


[1] Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA: A Cancer Journal for Clinicians. 2023; 73: 17–48.

[2] Achard V, Putora PM, Omlin A, Zilli T, Fischer S. Metastatic prostate cancer: treatment options. Oncology. 2022; 100: 48–59.

[3] Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II—2020 update: treatment of relapsing and metastatic prostate cancer. European Urology. 2021; 79: 263–282.

[4] Ryan CJ, Tindall DJ. Androgen receptor rediscovered: the new biology and targeting the androgen receptor therapeutically. Journal of Clinical Oncology. 2011; 29: 3651–3658.

[5] Wiegand LR, Hernandez M, Pisters LL, Spiess PE. Surgical management of lymph-node-positive prostate cancer: improves symptomatic control. BJU International. 2011; 107: 1238–1242.

[6] Crain DS, Amling CL, Kane CJ. Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. Journal of Urology. 2004; 171: 668–671.

[7] Rapiti E, Verkooijen HM, Vlastos G, Fioretta G, Neyroud-Caspar I, Sappino A. Complete excision of primary breast tumor improves survival of patients with metastatic breast cancer at diagnosis. Journal of Clinical Oncology. 2006; 24: 2743–2749.

[8] Temple LKF, Hsieh L, Wong WD, Saltz L, Schrag D. Use of surgery among elderly patients with stage IV colorectal cancer. Journal of Clinical Oncology. 2004; 22: 3475–3484.

[9] Flanigan RC, Salmon SE, Blumenstein BA, Bearman SI, Roy V, McGrath PC, et al. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. New England Journal of Medicine. 2001; 345: 1655–1659.

[10] Hallissey MT, Allum WH, Fielding JWL, Roginski C. Palliative surgery for gastric cancer. Cancer. 1988; 62: 440–444.

[11] Wang Y, Qin Z, Wang Y, Chen C, Wang Y, Meng X, et al. The role of radical prostatectomy for the treatment of metastatic prostate cancer: a systematic review and meta-analysis. Bioscience Reports. 2018; 38: BSR20171379.

[12] Heidenreich A, Pfister D, Porres D. Cytoreductive radical prostatectomy in patients with prostate cancer and low volume skeletal metastases: results of a feasibility and case-control study. Journal of Urology. 2015; 193: 832–838.

[13] Fossati N, Trinh Q, Sammon J, Sood A, Larcher A, Sun M, et al. Identifying optimal candidates for local treatment of the primary tumor among patients diagnosed with metastatic prostate cancer: a SEER-based study. European Urology. 2015; 67: 3–6.

[14] Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA: A Cancer Journal for Clinicians. 2022; 72: 7–33.

[15] Wang L, Paller CJ, Hong H, De Felice A, Alexander GC, Brawley O. Comparison of systemic treatments for metastatic castration-sensitive prostate cancer: a systematic review and network meta-analysis. JAMA Oncology. 2021; 7: 412–420.

[16] Antwi S, Everson TM. Prognostic impact of definitive local therapy of the primary tumor in men with metastatic prostate cancer at diagnosis: a population-based, propensity score analysis. Cancer Epidemiology. 2014; 38: 435–441.

[17] Zhao Y, Peng DS, Liang J, Lin YL, Qi JG. A systematic review and meta-analysis of comparative studies on the efficacy of cytoreductive prostatectomy in patients with metastatic prostate cancer. International Journal of Clinical and Experimental Medicine. 2020; 13: 330–339.

[18] Fidler IJ. The pathogenesis of cancer metastasis: the “seed and soil” hypothesis revisited. Nature Reviews Cancer. 2003; 3: 453–458.

[19] Poelaert F, Verbaeys C, Rappe B, Kimpe B, Billiet I, Plancke H. Cytoreductive prostatectomy for metastatic prostate cancer: first lessons learned from the multicentric prospective local treatment of metastatic prostate cancer (LoMP) trial. Urology. 2017; 106: 146–152.

[20] Marszalek M, Ponholzer A, Rauchenwald M, Madersbacher S. Palliative transurethral resection of the prostate: functional outcome and impact on survival. BJU International. 2007; 99: 56–59.

[21] Qin X, Ma C, Ye D, Yao X, Zhang S, Dai B, et al. Tumor cytoreduction results in better response to androgen ablation—a preliminary report of palliative transurethral resection of the prostate in metastatic hormone sensitive prostate cancer. Urologic Oncology: Seminars and Original Investigations. 2012; 30: 145–149.

[22] Choi SY, Ryu J, You D, Jeong IG, Hong JH, Ahn H. Oncological effect of palliative transurethral resection of the prostate in patients with advanced prostate cancer: a propensity score matching study. Journal of Cancer Research and Clinical Oncology. 2018; 144: 751–758.

[23] Qu M, Zhu F, Chen H, Lian B, Jia Z, Shi Z. Palliative transurethral resection of the prostate in patients with metastatic prostate cancer: a prospective study of 188 patients. Journal of Endourology. 2019; 33: 570–575.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.9 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time