Low Prostate Cancer-Specific Mortality Seen for Men With Localized Disease

Prostate cancer-specific mortality was low for men randomly assigned to active monitoring, prostatectomy, or radiotherapy
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Medically Reviewed By:
Mark Arredondo, M.D.

MONDAY, March 13, 2023 (HealthDay News) -- For men with localized prostate cancer, prostate cancer-specific mortality is low at 15-year follow-up, regardless of treatment assigned, according to a study published online March 11 in the New England Journal of Medicine to coincide with the annual congress of the European Association of Urology, held from March 10 to 13 in Milan.

Freddie C. Hamdy, M.D., from the University of Oxford in the United Kingdom, and colleagues enrolled 1,643 men with localized prostate cancer in a trial to examine the effectiveness of treatments, with 545, 553, and 545 randomly assigned to active monitoring, prostatectomy, and radiotherapy, respectively. Outcomes were compared at a median follow-up of 15 years; follow-up was complete for 1,610 patients.

The researchers found that 2.7 percent of the men had death from prostate cancer: 3.1, 2.2, and 2.9 percent in the active-monitoring group, the prostatectomy group, and the radiotherapy group, respectively. Overall, 21.7 percent of the men had death from any cause, with similar numbers seen in the three groups. Metastases developed in 9.4, 4.7, and 5.0 percent of men in the active-monitoring, prostatectomy, and radiotherapy groups, respectively. Long-term androgen-deprivation therapy was initiated in 12.7, 7.2, and 7.7 percent of men, respectively; clinical progression occurred in 25.9, 10.5, and 11.0 percent, respectively. At the end of follow-up, 24.4 percent of men in the active-monitoring group were alive without any prostate cancer treatment.

"Men with newly diagnosed, localized prostate cancer and their clinicians can take the time to carefully consider the trade-offs between harms and benefits of treatments when making management decisions," the authors write.

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