Results from a randomized clinical trial out of the University Hospital in Uppsala, Sweden reveals compelling evidence that radical prostatectomy provides a survival benefit, as well as a reduction in the risk for metastases, in some men who have been diagnosed with early-stage prostate cancer.
The study showed that after having their prostate removed surgically, fewer men under 65 years-of-age died from prostate cancer at the 15 years mark than did those who didn’t have the surgery. The incidence of death from prostate cancer was 14.6% among 347 men randomized to receive a prostatectomy, and 20.7% among 348 men only being observed without treatment.
“Radical prostatectomy appears to be a wise choice for men with early-stage prostate cancer who are younger than 65 years,” according to lead study author Anna Bill-Axelson, MD Ph.D.
For men older than 65 years, survival was highly similar in the 2 groups.
“This is the best information we have to date on the extent to which surgery will influence outcomes in men with early prostate cancer,” said H. Ballentine Carter, MD, from Johns Hopkins University in Baltimore, MD.”
The most surprising results from this study indicate that a patient’s age — and related life expectancy — are apparently pivotal with respect to the benefits of having surgery vs. watchful waiting in men with early-stage prostate cancer.
“If you are 65 years or older,” Dr. Carter said, “your first consideration should be whether or not surgery is necessary. Such men should consider being monitored instead.”