Radical Prostatectomy Has Lasting Benefit for Localized Cancer

THURSDAY, Dec. 13, 2018 (HealthDay News) — Men with localized prostate cancer benefit from radical prostatectomy, with a mean of 2.9 years gained, according to a study published in the Dec. 13 issue of the New England Journal of Medicine.

Anna Bill-Axelson, M.D., Ph.D., from Uppsala University Hospital in Sweden, and colleagues randomly assigned 695 men with localized prostate cancer to watchful waiting or radical prostatectomy from October 1989 through February 1999, with follow-up through 2017.

The researchers found that 261 of the 347 men in the radical-prostatectomy group and 292 of 348 in the watchful-waiting group had died by Dec. 31, 2017. Overall, 71 and 110 deaths in the radical-prostatectomy and watchful-waiting groups, respectively, were due to prostate cancer (relative risk, 0.55). To avert one death from any cause, the number needed to treat was 8.4. A mean of 2.9 extra years of life were gained with radical prostatectomy at 23 years. Among men who underwent radical prostatectomy, extracapsular extension versus no extracapsular extension correlated with a five times greater risk for prostate cancer death; a Gleason score greater than 7 versus 6 or lower was associated with a 20 times greater risk.

“In clinically detected prostate cancer, the benefit of radical prostatectomy in otherwise healthy men can be substantial, with a mean gain of almost three years of life after 23 years of follow-up,” the authors write.

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