Long-term follow-up found no significant differences in all-cause or disease-related mortality in men with early prostate cancer randomized to either radical prostatectomy or to observation. Surgery led to more adverse events, but less treatment for disease progression. “In light of the protracted disease course and extended survival of many patients, treatment decisions often require information about additional treatments received, patient-reported outcomes, and very-long-term mortality,” wrote study authors led by Timothy J. Wilt, MD, MPH, of the University of Minnesota School of Medicine in Minneapolis.
A previous report from this study showed no difference in mortality outcomes through 12 years. The new analysis includes follow-up out to 19.5 years for a cohort of 731 men diagnosed with localized prostate cancer and randomized to either radical prostatectomy (364 patients) or observation (367 patients). Results were publishedonline ahead of print today in the New England Journal of Medicine.
The cumulative incidence of death was 61.3% in the surgery patients, and 66.8% in the observation patients, for a hazard ratio (HR) with surgery of 0.84 (95% CI, 0.70–1.01; P = .06). Although the absolute difference in mortality risk was not significant, it did increase from 3.1 percentage points at eight years to 5.5 percentage points at the end of follow-up. The median survival was 13 years with surgery and 12.4 years with observation.
Source: Cancer Network
