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Posted by on Apr 9, 2020 in Prostate cancer | 0 comments

In a nutshell

The study compared the long-term outcomes of prostate surgery (radical prostatectomy; RP) and observation (watchful waiting; WW) in patients with early prostate cancer. The study showed that surgery reduced mortality in these patients. 

Some background

Prostate cancer is one of the most common cancers in American men. Early intervention such as RP or radiation therapy of localized (early stage) prostate cancer is controversial. This treatment can result in more urinary and sexual complications. These can negatively impact overall physical comfort.

However, the benefits of early intervention are that it slows down disease progression. The long-term impact of RP compared to WW in patients with early-stage prostate cancer are still unknown.

Methods & findings

731 patients with localized prostate cancer were included in this study. They were randomly divided into two groups. Group 1 underwent RP. Group 2 underwent observation or WW. The WW group was offered supportive therapy or chemotherapy in case the cancer got worse. Patients were followed up for an average of 18.6 years.

Surgery was associated with a 16% lower risk of mortality compared to WW. Patients who most benefited from surgery were younger, healthier and with intermediate risk of spread of the disease. 

The bottom line

The authors found that in the long-term, surgery was associated with lower mortality compared to observation in men with localized prostate cancer. 

The fine print

Due to the long-term follow-up, more than 70% of men died during the study. Due to limited medical records, the cause of death and whether it was related to prostate cancer could not be properly assessed. 

What’s next?

If you have concerns regarding prostate cancer management, please discuss this with your doctor.

Published By :

European Urology

Date :

Feb 20, 2020

Original Title :

Radical Prostatectomy or Observation for Clinically Localized Prostate Cancer: Extended Follow-up of the Prostate Cancer Intervention Versus Observation Trial (PIVOT).

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