Prostato-Vesiculectomy in 20 Patients with Malignant Prostatic Tumour

Radical prostato-vesiculectomy has been performed in 20 patients for malignancy of the prostate. In one patient a sarcoma of the prostate was diagnosed. The patient is alive and well 3 years after the operation without sequelae. In 19 patients preoperative fine needle biopsy revealed carcinoma of the prostate. Prostato-vesiculectomy was performed in an attempt at complete removal of the cancer, since preoperative findings suggested that the tumour growth was confined to the prostate gland. At the time of operation, however, cancerous growth beyond the limits of the prostate was recorded histologically in 6 of the 19 cases. Postoperatively, there were only two cases of incontinence both of them slight. All patients survived the operation. In 7 of the 19 cases postoperative metastases have been recorded. In these cases endocrine therapy was begun. One patient died less than 2 years postoperatively from widespread metastases, the remaining 18 patients are alive and well 2 '/a-9 years after the operation. It is concluded that in selected cases radical retropubic prostato-vesiculectomy can be performed with no serious side effects. A substantial number of the operated patients will be rid of their cancer and will require no further therapy. In those patients where cancer is growing beyond the limits of the prostate at the time of operation endocrine therapy can be begun at once. In cases of metastases detected later on, the endocrine therapy remains as an alternative. Preoperative fine needle biopsy and cytological examination was found to be a good way of evaluating the degree of malignancy of the tumour. The results with this technique were in agreement with the postoperative histological findings. Preoperative cytology can be trusted in deciding the mode of treatment in the individual patients.