Prostate Surgery May Not Decrease Death Toll in Low-Risk Prostate Cancer Patients, Long-term Study Finds

Prostate Surgery May Not Decrease Death Toll in Low-Risk Prostate Cancer Patients, Long-term Study Finds
In a follow-up study spanning almost 20 years, researchers found that surgery does not decrease mortality outcomes in patients with localized prostate cancer. In fact, the results showed that surgery is associated with a higher frequency of adverse events, such as infection, urinary incontinence, and erectile dysfunction. The study, “Follow-up of Prostatectomy versus Observation for Early Prostate Cancer,” was published in The New England Journal of Medicine. Previously, the team of researchers at Washington University School of Medicine, led by the Minneapolis Veterans Administration Health Care System, had found no significant differences in mortality when they compared men with localized prostate cancer who underwent surgery with those who received observation only. Now, researchers extended their analysis to evaluate surgery effects in terms of nonfatal health outcomes and long-term mortality. In one of the largest trials conducted with cancer patients, the Prostate Cancer Intervention Versus Observation Trial (PIVOT, NCT00007644) researchers randomly assigned 731 men with localized prostate cancer to radical prostatectomy or observation. The observation group was treated only if they developed symptoms, including urinary difficulty or bone pain, which may indicate cancer progression. Patients, all less than 75 years of age, were followed during 19.5 years and in this period researchers registered a death toll of 61.3 percent (223 of 364 men) in the group assigned to surgery and 66.8 percent (245 of 36
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