Conservative Treatment of Carcinoma of the Prostate

• The case records of 1,560 patients who had carcinoma of the prostate were reviewed. Transurethral prostatic resection was performed in each case. During the 20 years represented by this series the percentage of patients who lived five years or more after operation increased steadily, and in the period from 1942 to 1946 it was 39.2%. The improvement is only in part attributable to the advent of orchiectomy and hormone therapy, for it is seen also in other types of cancer. The average amount of tissue removed was less than 20 gm. The removal of less than 30 gm. sufficed to relieve the urinary obstruction in the large majority of patients, and only 173 had to return for reoperation in later years. The grades of malignancy assigned to the lesions on pathological examination were strongly correlated with survival time. Five patients in whom metastasis had occurred were strikingly benefited by orchiectomy and/or diethylstilbestrol by mouth. A spirit of optimism should be maintained in the treatment of any patient with carcinoma of the prostate.