Surgery Does Not Reduce All-Cause Mortality among Men with Localized Prostate Cancer – Study

September 5, 2012 by  
Filed under Prostate Cancer News

Contrary to what many will see as helping to reduce the mortality rate in men with localized prostate cancer, a new study from published in the New England Journal of Medicine has concluded that radical prostatectomy does not lower the risks of death for men with this disease any better those who received active  surveillance or observation as treatment.

This study was conducted by researchers from the University Of Minnesota School Of Medicine in Minneapolis, MN. Details of the study carried out in about 731 men studied after a period of about 10 years are revealed below:

More diagnoses and treatments mean more income for hospitals, but they do not necessarily bring patients extra benefits. A new study in the New England Journal of Medicine suggests radical prostatectomy following prostate specific antigen (PSA) test does not lower risk of death from all causes in patients with localized prostate cancer.

The study led by Timothy J. Wilt, M.D., M.P.H. of University of Minnesota School of Medicine in Minneapolis, MN and colleagues found all cause mortality in both the group of localized prostate cancer receiving prostatectomy and the group receiving observation remained the same.

The data used for the study came from 731 men at a mean age of 67 years with localized prostate cancer featured with a median PSA value at 7.8 ng per mL who were randomized to receive either radical prostatectomy or observation and were followed for 10 years on average, starting between Nov. 1994 and Jan 2002 and ending in Jan 2010. The outcomes considered in the study included all-cause mortality and prostate specific mortality.

During the median 10-year follow-up, 171 of 364 men or 47 percent who received radical prostatectomy died, compared to 183 of 367 men or 49.9 percent assigned to observation.  Of men who were assigned to radical prostatectomy, 21 or 5.8 percent died from prostate cancer or treatment, compared to 31 men or 8.4 percent assigned to observation.

However, the researchers found prostate cancer surgery did not reduce the all-cause and prostate cancer mortality, compared to those who did not receive prostate cancer treatment after adjustment for age, race, coexisting conditions, self-reported performance status, and history of the tumor.

Radical prostatectomy was correlated with reduced all-cause mortality only among men with a PSA value greater than 10 ng per milliliter and possibly among men with intermediate-risk or high-risk tumors.

Radical prostatectomy was associated with adverse events within 30 days of surgery in 21.4% of men including one death.

The researchers concluded “Among men with localized prostate cancer detected during the early era of PSA testing, radical prostatectomy did not significantly reduce all-cause or prostate-cancer mortality, as compared with observation, through at least 12 years of follow-up.”  Source.

This is quite a revelation, although not completely unexpected. PSA testing for men has in recent times become controversial as there are diverging opinions among medical professionals concerning the benefits of this test.

Those against this test will find the above study as supporting evidence. However, it still boils down to the fact that doctors and their patients really need to be decisive on this test and the kind of treatments they go for.

Of course this is important after weighing the advantages and disadvantages of the different kinds of treatments. This particularly applies to men with prostate cancer.

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