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Treatment vs surgery in prostate cancer

Quick surgery not a benefit to men diagnosed early with prostate cancer, according to a study published on New England Journal of Medicine.

The conclusions of the study said: “Among men with localized prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up. Absolute differences were less than 3 percentage points.

From November 1994 through January 2002, the experts randomly assigned 731 men with localized prostate cancer (mean age, 67 years; median PSA value, 7.8 ng per milliliter) to radical prostatectomy or observation and followed them through January 2010. The primary outcome was all-cause mortality; the secondary outcome was prostate-cancer mortality.”

“During the median follow-up of 10.0 years, 171 of 364 men (47.0%) assigned to radical prostatectomy died, as compared with 183 of 367 (49.9%) assigned to observation. Among men assigned to radical prostatectomy, 21 (5.8%) died from prostate cancer or treatment, as compared with 31 men (8.4%) assigned to observation.

The effect of treatment on all-cause and prostate-cancer mortality did not differ according to age, race, coexisting conditions, self-reported performance status, or histologic features of the tumor.

Radical prostatectomy was associated with reduced all-cause mortality among men with a PSA value greater than 10 ng per milliliter and possibly among those with intermediate-risk or high-risk tumors. Adverse events within 30 days after surgery occurred in 21.4% of men, including one death.” (SOURCE: New England Journal of Medicine)

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