New Analysis Contradicts Previous Finding of No Benefit in Prostate Surgery for Early-Stage Patients

New Analysis Contradicts Previous Finding of No Benefit in Prostate Surgery for Early-Stage Patients
A new analysis of three large U.S. cancer databases indicates that a previous influential study that found no benefit to prostate surgery in the early stages of cancer does not reflect real-world patients. Contrary to what the study suggested, men with localized prostate cancer might benefit from prostate surgery, or prostatectomy. A definitive study is now needed to show the relative benefits of intervention versus observation, researchers say. The findings, by researchers at the Henry Ford Hospital in Detroit, were recently presented at the European Association of Urology congress (EAU) after publication as a letter, titled “Re: Follow-up of Prostatectomy Versus Observation for Early Prostate Cancer,” in the journal European Urology. Researchers’ analysis show that the PIVOT study (NCT00007644), the results of which were published in 2017 in the The New England Journal of Medicine, selected a group of patients that may have biased their conclusions. "It was clear from the first PIVOT analysis in 2012, that surgery (radical prostatectomy) had an advantage over waiting in patients with a poor prognosis. Now this evaluation of the dataset used in PIVOT suggests that the balance needs to change even in early-stage prostate cancer patients. This raises significant questions over just how relevant PIVOT is to real prostate cancer patients, and we need to seriously re-evaluate the PIVOT study, before taking implementation any further," Hein Van Poppel, MD, a professor at UZ Leuven in Belgium and the EAU adjunct secretary-general, said in a press release.  PIVOT was a long-term follow-up on low-, intermediary- and high-risk prostate cancer patients lasting nearly 20 years. It randomly assigned 731 men with localized prostate cancer either to radic
Subscribe or to access all post and page content.