Prostatectomy vs. Watchful Waiting in Early Prostate Cancer

Compared with watchful waiting, radical prostatectomy resulted in fewer deaths from prostate cancer, but urinary incontinence and decreased sexual function were more common with surgery.

Men with early prostate cancer have a choice of undergoing surgery or radiotherapy, or watchful waiting. This Scandinavian study is the first recent comparative trial: 695 men (mean age, 65) with early prostate cancer were randomized to radical prostatectomy or to watchful waiting. Most tumors (76%) were palpable but were clinically confined to the prostate; the others were discovered by prostate-specific antigen testing (12%) or incidentally during transurethral prostatectomy for benign disease (12%).

During a median follow-up of 6.2 years, death from prostate cancer occurred significantly less often in the surgery group than in the watchful-waiting group (4.6% vs. 8.9%). However, a modest excess of deaths from other causes occurred in the …

Reviewing Author

Allan S. Brett, MD